24 hours after Belotero: is this swelling, too much product, or too superficial of an injection? (photos)

Question

Had Belotero injected into my tear troughs yesterday. I've had fillers and Botox, never looked like this before! I know the bruising is probably because she nicked a vessel. But the bulging seems extreme/in concentrated areas only, and it doesn't feel tight like skin feels when it's just swollen. I've massaged, iced, used arnica cream, doesn't seem better. Dr. used a needle and injected 1/2 a syringe under each eye. Is this swelling, too much product, or was it injected too superficially?

Paul S. Nassif, MD · Answer

In general, it can take 1-2 weeks to see the final result of Belotero treatment; it is a bit too early to assess the result and you will need some more time for the remainder of the swelling to resolve. I would recommend speaking with your provider about any questions in the meantime; he/she is familiar with the nature of your treatment. I hope this information helps, and I wish you the best of luck.

Young R. Cho, MD, PhD · Answer

Thank you for your questions and sharing your photos. After one day, it is too difficult to assess the final results. You'll need to wait a couple weeks for all the bruisin and swelling to come down. Is also difficult to ask what  you of shoes thank you for your questions and sharing your photos. It Is also difficult to tell what depth your injector placed the product based on photos alone.  However, when the product is placed superficially, there is an increased chance of swelling.

Sirius K. Yoo, MD · Answer

24 hours after injection is too early to assess.  There will be inflammation from the needle injection sites that can last for several days depending on the sensitivity of the skin as well as the after care.  Definitely ice for 2-3 days given that you are bruising, continue with the Arnica and hopefully after a week you will have the results you were expecting.  You may want to look into injections with blunt cannulas as there is usually no bruising and less swelling after injection.

Dilip D. Madnani, MD, FACS · Answer

At 24 hours you probably have swelling from the procedure. I would suggest waiting a full week, ice the area for about 48 hours then reassess. If its still bulging, then ask to have some of the product removed with hyaluronidase. Belotero can be tricky to inject sometimes, and there can be occasional issues with lumpiness- usually its just swelling which tends to resolve, if not, then the above suggestion should work great.

Dan Landmann, MD · Answer

Belotero is unique, in that people often get red and swollen immediately afterwards. This should resolve in the next few days. Fillers under the eyes will commonly cause more bruising, swelling and skin discoloration that other places on the face. However, once a bruise starts to develop, it is normal for it to get worse for the next several days before it gets better - so don't be disheartened if it gets worse tomorrow. I'd give it sometime and reassess in about 2 weeks. For now, gentle ice is best. Just make sure to set a follow up appointment with your doctor to share your concerns.

Alim R. Devani, MD, FRCPC · Answer

I always tell my patients to not love their filler
injections for 2 weeks. Swelling is very common and sometimes immediate. It can
last 3-7 days and a good idea is to use cold compresses. Cold compresses may be
used immediately after treatment to reduce swelling only if needed. This may be
applied for 3 minutes, 3 times per day, for up to 3 days. This is best done
with a bag of peas in a zip lock bag. Only apply light pressure to the area but
gentle massage might be necessary if the bump is from the filler material
itself. Get Arnica gel if you can find some and apply a few times a day as well
to help treat any swelling. Avoid any blood thinners. Bruising can also last
1-2 weeks. I don't recommend hyaluronidase this early and wait a few weeks
until the swelling has resolved. If it is persistent or you are worried, set up
a follow up appointment with your dermatologist.

Dara Liotta, MD, FACS · Answer

Some swelling is normal in the first few days following injection of filler in the tear troughs. The skin under the eye is very thin, and even a small amount of swelling can look dramatic. I tell patients that the final results of filler, after all of the initial swelling, possible bruising, and water absorption has resolved, can take up to  weeks under the eye.  If you still have this puffiness 2 weeks after injection, I would recommend following up with your surgeon for possible injection of hyaluronidase (vitrase) to dissolve some of the filler. The process of dissolving filler is very easy and excess filler will resorb in 24 to 48 hours.

Leslie M. Sims, MD (in memoriam) · Answer

It is not uncommon to have edema (swelling) and ecchymosis (bruising) one day after tear trough injections with fillers.  The periorbital skin (eyelid skin) is so very then and somewhat unforgiving. The appearance of swelling can seem dramatic; also blood vessels are very superficial in that area.  It may take up to two weeks to achieve your final results.  There is a substance that can be used to dissolve/absorb the product should the edema and or lumps/bumps persist. I hope this helps. Good luck to you.

24 hours after Belotero: is this swelling, too much product, or too superficial of an injection? (photos)

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