Does filler to the cheek usually cause bruising?

Question

Does injection of filler specifically in the hollow of the cheeks typically cause bruising? Is there anyway to avoid? Does administration technique have any bearing?

James M. Economides, MD, FACS · Answer

Yes, filler injections in the hollow of the cheeks can potentially cause bruising, but there are ways to minimize the risk. Bruising occurs when the needle or cannula used during the injection hits small blood vessels beneath the skin. Several factors, including the injection technique, play a role in whether bruising happens.

1. Administration Technique:
Cannula vs. Needle: Using a cannula instead of a needle can reduce the risk of bruising. Cannulas are blunt-tipped and less likely to puncture blood vessels compared to needles, making them a popular choice for areas prone to bruising, such as the cheeks.
Experienced Injector: A skilled injector familiar with facial anatomy will be more likely to avoid blood vessels during the injection, minimizing the chance of bruising. The injector's technique, such as injecting slowly and avoiding over-manipulation of the tissue, can also help reduce trauma to the area.
Layer of Injection: Injecting the filler deeper into the tissue, where there are fewer superficial blood vessels, can also lower the risk of bruising.
2. Ways to Avoid Bruising:
Avoid Blood Thinners: Stop taking aspirin, ibuprofen, and other blood-thinning medications or supplements (like fish oil or vitamin E) for about a week before the procedure, unless medically necessary.
Avoid Alcohol: Refrain from drinking alcohol for at least 24-48 hours before your injection, as it can thin the blood and increase the likelihood of bruising.
Cold Compresses: Applying a cold compress to the area before and after the injection can constrict blood vessels and help prevent bruising.
Arnica or Bromelain: Some people use Arnica gel or Bromelain supplements before and after the procedure to reduce bruising and swelling.
Post-Treatment Care: After the procedure, avoid strenuous activity, excessive heat (like saunas), and massaging the area for the first 24-48 hours to minimize trauma.
3. Expectations:
Even with all precautions, some people may still bruise due to their skin’s sensitivity or underlying vascularity. However, working with an experienced injector who uses appropriate techniques (like a cannula) and following pre- and post-care instructions can significantly reduce the chances.

George Gavrila, MD · Answer

Thank you for your question. With any injection bruising can be a result. However proper technique can limit the chances. At our office our providers are specially trained in a manner that lower risks of bruising or any trauma to the skin. Understanding the vascular anatomy of the face is crucial to assuring minimal post procedural bruising.

John Tang, MD · Answer

Typically injecting fillers in the cheeks usually results in less bruising compared to the eyes or around the chin.  This is because there is usually less blood vessels in this area compared to the eyes.Technique is quite important to lessen bruising.  This is universally true for all areas.  There are quite a few tricks of the trade which means that experience counts!To lessen bruising in general you can avoid taking NSAIDS like aspirin, motrin, or aleve (if medically appropriate to do so) for 1 week prior to treatment,  avoid fish oil, higher doses of garlic, ginger, or gingko for at least 5 days.  You can also apply Arnica to the injected area 1 day prior to treatment or take Arnica pills 2 days prior to help lessen the risk of bruising.You can also use ice before the treatment which helps constricts the blood vessels.  I have a topical constrictor with my numbing cream which helps tremendously.Hopefully that helps.  Good luck!

Michael A. Zadeh, MD, FACS · Answer

Bruising is a risk with any treatments that involve needle injections, including fillers. There are ways to minimize the risks of bruising, but it will always be a possibility even in the most expert of hands. Bruising can last for up to 2 weeks. Certain areas of the face have more risk of bruising than others. On the whole, my patients rarely bruise after cheek fillers. Make sure you are under the care of an experienced physician to minimize the risk of bruising. Best wishes.

Jason Emer, MD · Answer

It is common to have swelling and some bruising for a couple weeks after fillers. If the swelling persists, be sure to return to your physician (or see a cosmetic dermatologist and facial sculpting expert) for a formal evaluation. If you're unhappy with your results, you can always have the filler dissolved with hyaluronidase. See an expert. Best, Dr. Emer.

Daniel Maman, MD · Answer

There are many factors which could contribute to a bruise after treatment with filler to the cheeks. Technique is one of these factors. Another would be any medications or vitamins you may have been taking at the time of treatment - blood thinners such as aspirin or vitamin E can put you at higher risk. Some providers use surgical lighting or a vein finder to best-avoid underlying blood vessels which could cause a bruise if punctured. Consult with your board-certified plastic surgeon or dermatologist to learn the best way to prep for treatment with dermal fillers and get the more from your experience.
Best of luck!

Shaun Patel, MD · Answer

Any injectable treatment could lead to bruising include cheek filler treatment. I would avoid blood thinners prior to your treatment as well as ice before and immediately after the treatment. A vascular laser like the VBeam could be used to treat any bruising. Using a microcannula to inject the filler can in my opinion minimize the risk of bruising.

Imad Aziz El-Asmar, MD · Answer

Thank you for your question.We are all unique in wound healing capabilities, it can happen. Seeking an experienced injector is key. Ice packs for the initial 24-48 hours, avoiding alcohol, and sugars, as well as not sleeping on your face will reduce the chances. We also recommend arnica sublingual tablets or eating some pineapple to speed up your body's ability to break it down. Of course, check with your provider first and foremost.
 Best,
Dr. El Asmar

Robert L. Kraft, MD, FACS · Answer

It is common for filler injection to result in bruising. Everyone is different and injector technique is also important.  The thinner fillers, such as Restylane, result in less bruising, in my opinion.  The extent and duration of bruising will vary. I find that if patients are diligent with ice packs during the first 24 hours and also use a topical such as Dermend, the bruising will be reduced.

Does filler to the cheek usually cause bruising?

Answers (9)

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