Hematoma from lip injections? What do I do?

Question

I just got juvaderm in my top lip and now have bruising and what appears to be a hematoma. It just feels really swollen and kind of hurts, but not terrible. What do I do? I'm icing it right now. I called my doctor but only got VM. A little worried. This is my first time having anything done.

Daniel Barrett, MD · Answer

Dear magshal,Juvederm has significant swelling post injection. I would follow up with you plastic surgeon but typically I tell all my patients to wait a full two weeks.  Generally at 2 weeks they are happy and glad they didn't dissolve. You can try icing it and keep your head elevated. Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Tim Sayed, MD, MBA, FACS · Answer

Hematoma is rare after lip injections but can happen if a blood vessel is directly punctured and/or the patient is on blood thinners. Icing should help as will time. Probably wise to avoid aspirin or NSAID drugs like ibuprofen/naprosyn/alleve until the swelling and bruising resolve. Your physician could drain the hematoma with a small needle prick if it's superficial but it is likely to go away on its own in time. The risk of trying to drain a small hematoma is the potential to infect the filler (rare as well) or to end up having some of it extruded when the blood is evacuated. I suggest close followup with your doctor.

Craig R. Dufresne, MD · Answer

Dear magshal,
I would recommend after 48 hours of icing change to warm compressor, it should resolve over time.

Steven F. Weiner, MD · Answer

A hematoma is possible after lip injections and will eventually resolve. It is not dangerous. I would treat with oral arnica and a vascular laser to shorten the duration of the bruising. Using cannulas will decrease the risk of this as well as an experienced injector.

Reza Tirgari, MD · Answer

Bruising is fairly common after injectables, especially in areas that have a lot of blood vessels such as the lip.  We take especial care for this reason to take precautions that minimize bruising, and have had a great deal of success with limiting or even eliminating this.
However, once bruising does occur, a little pressure immediately after the injection can reduce the amount of spread.  If there has been some time that has passed, alternating warm and cold compresses can sometimes help speed up your body's process of absorbing the hematoma.  Ultimately it will go away on it's own.

Monica Bonakdar, MD · Answer

Sorry to see that your first experience with lip fillers has been challenging. Rest assured that injection induced bruises heal completely on their own with time. However, there are many things that can be done to heal them faster. 
1. Use warm compresses- 3-5 minutes 3-5 times per day until bruising completely resolves.
2. Start Arnica Pills and Cream- This homeopathic medication can be purchased at a health food store. Follow manufacturer recommendation until bruising completely resolves.
3. Start Sente Eye Cream- Contains ingredients that are known to heal bruises faster. 3-5 times per day until bruising completely resolves.
4. Start in office Intense Pulse Light daily treatments- Proven by multiple published papers to heal bruises faster. 
5. Have pineapple fruit or  juice daily until bruising completely resolves-Known to heal bruises faster
Best practices in the community who are experts at filler treatments provide their patients with at least one cell phone number so that they can reach the physician or the clinical staff 24/7 in case of such problems. This level of customer service and patient care is part of what you pay for when you choose such a practice.  Many people unfamiliar with the possible risks and challenges involved with injections choose their injector based on price and get into trouble afterwards.
Best of luck healing this unwelcomed hematoma, 
Monica Bonakdar, MD

Shaun Patel, MD · Answer

There is nothing to be worried about. Bruising and swelling are not uncommon after lip filler treatment. This will improve over the next few days but may take up to 2 weeks to completely resolve. Initially, ice packs will help with the swelling and to stop any bleeding. After 24-48 hours, you can switch to heat packs as needed.

Leonard Grossman, MD · Answer

Hematomas or bruising do occur in some patients after lip augmentation. Applying moist, warm compresses frequently will  help resolve the hematoma much quicker. Once the hematoma has resolved the swelling will come down rather quickly. Be patient and I'm sure you will be happy with your results. Good luck from New York City

Laurene DiPasquale, MD · Answer

Thank you for your question.  It is fairly common to have significant swelling and some bruising after having injections in the lips.  Icing is recommended.  The lips generally heal after about 2 weeks, although you will be seeing small improvements every day.  If you are not happy after 2 weeks, return to your injector, earlier if the lip swelling and bruising appear to be worsening.

Hematoma from lip injections? What do I do?

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