Discoloration of Skin in Area of Injections - Botox & Juvederm Combination

Hi MM.  Sorry to hear about this negative experience.  If the bruising has left a darker colored area and you are also olive skin tone or darker, it could be related to a condition called hemosiderin staining.  This condition happens more frequently with sclerotherapy (vein injections) but we have seen it in the face before as well.  The profound bruising causes some more permanent brownish discoloration.  

We have treated this condition successfully with q-switched Nd:Yg lasers so if your injector thinks this is what he/she is seeing, this is definitely an option.

Alternatively, if the color is blueish in nature, it could be the Tyndall effect.  This is caused by superficial placement of hyaluronic acid products like Juvederm.  Normally this will go away in several months, but you may consider getting Vitrase injections to reverse the effects of the Juvederm if the area is bothering you too much to wait.

Redness does not seem consistent with coloration for 2 weeks after injection so you should ask your injector about this.

bruising is not uncommon after some fillers and less so with Botox.  Bruises tend to fade in two to three weeks but post inflammatory hyperpigmentation may take months or more to fade. Some people's skin shows a sensitivity that heals with fine capillary blood vessels and this redness can take a long time to go away.  keep out of the sun! V-beam laser can minimize the redness quickly if it is a persistent problem.

Certain things in our diet predispose us to bruise.  Virtually any herbal product out there seems to increase the risk of bruising.  Of course taking drugs like aspirin and motrin also inhibit platelets and increases the risk of bruising in association with any treatment that must be injected with needles.  The heavy bruising you are describing does not clear in a week.  No it takes up to a month and rarely longer for all of this to clear.  I suspect that if you give it that much time, I think you will see all of this discoloration resolve.  Also, don't let people inject your lips with BOTOX.  Perhaps you should take this episode as a sign to find a new injecting physician who is not so heavy handed.

Generally after injections you may have some redness which resolves after 24 hours or so.  Continued discoloration is unusual.  You really need to post a picture or be seen in person for more specific advice.

 

Good Luck.

I always apply a topical anesthetic cream (which includes a medication that causes blood vessels to constrict) before injecting "fillers" such as Juvederm and Restylane). The skin is numbed for the injection and is also much less likely to bruise. Bruising is usually minimal to nonexistent.

I usually do not use anesthetic cream prior to Botox injections; the key to preventing bruising is for the physician to immediately apply pressure to the injection site if any bleeding is noted. Again, bruising is usually minimal to nonexistent.

It is also a good idea for patients who are scheduled for injections to avoid any elective "blood thinning" medications such as aspirin for two weeks prior to the procedure.

If you bruised so badly than this COULD be a stain deposit of the blood. Best to be seen by the injecting doc to discuss and treat. 

At 8 weeks bruising should generally be gone unless you are taking aspirin or plavix. There is a phenomenon called the Tindal effect which occurs when hyaluronic acid fillers are to superficial and a bluish color is seen in the area of injection.

There can be traces of left-over bruising after any injection therapy.  Sometimes this takes a surprising amount of time to clear, or rarely, doesn't completely clear.  Laser treatments can promote complete clearing.  In other instances, there is a mild inflammatory reaction to the injection or the filler.  This can cause mild redness or tenderness that can last for a number of weeks.  Usually this is self-limited and will clear on its own.  If it is worsening or not clearing after several weeks, a return visit to your provider is called for to evaluate treatment options which sometimes include a topical or injected anti-inflammatory medicine or an antibiotic.

It is possible to get bruising swelling after treatments that may last a few weeks. If it is severe enough you may have discoloration that may last for a while or be permanent (although that is extremely rare). You need to give it time up to six months or even a year!

Most important is to avoid sun exposure to the areas with the discoloration!!!! 

If no improvement is seen IPL or bleaching creams maybe used!

Good luck!

Without a photograph, I can speak only in generalities but, if you had deep bruising from the filler and Botox, the swelling may not be completely resolved. I hope that you saw an experienced injector who is a board certified plastic surgeon or dermatologist!