Preventing Restylane Bruising

Doctor Answers 11

There's always a risk of bruising, but it can be reduced

Anytime a needle is placed through the skin, the risk of bruising exists. In my practice, I do several things to help reduce this risk when injecting fillers (juvederm, restylane, etc) or Botox. While some of this can be overkill, it at least gives my patients some options to help minimize their chances of having a bruise:

1) I ask patients to not take aspirin or ibuprofen for a few days before and after the procedure

2) No heavy exercise for 24 hrs after the procedure (when you really get your heart pumping and the blood pressure up, it can increase the chance of a small bruise)

3) For patients who tell me they bruise easily, I also ask them to refrain from alcohol for a day or so around the procedure. In addition, certain herbal meds can increase the chance of bruising as well, so those can be stopped before the procedure.

Finally, and most importantly I think, it does come down to the technique of the surgeon injecting, and experienced injectors in general have a very low bruising rate. Most of us will have our patients ice before and after the procedure, and ask them to ice for several hours afterwards as well if possible. Despite this, there is always a risk, so I tell my patients to be prepared for this, and we can usually use simple makeup to cover the area while the bruising subsides.

Dr. S

Seattle Plastic Surgeon
4.9 out of 5 stars 149 reviews

Prevent Bruising from Restylane, Perlane Juvederm, Botox and Prevelle Injections

In my practice we ice the area to be injected to reduce pain and the possibility of bruising. I also encourage people to avoid asprin products prior to receiving a dermal filler. For individuals who tend to bruise very easily, arnica montana might even be an option.

Select a physician or cosmetic injector with a great deal of experience and expertise using dermal fillers.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Reducing the risk of bruising, a scientific point of view

Thanks for the question. It is not necessarily unavoidable, but it is common. It is such a problem and we all have issues with bruising and fillers. The key is trying to prevent it. I've recently wrote an editorial discussing research into this area. Perhaps it would be of help? There are so many things out there that are misunderstood. I hope this article helps clarify some confusion with respect to what can and can not cause/help bruising.

I go over alot of information so hopefully it helps in the future!

James P. Bonaparte, MD, MSc, FRCSC
Head and Neck Surgery
practicing in Facial Plastic and Reconstructive Surgery
Assistant Professor, University of Ottawa
Ottawa, Ontario, Canada

James Bonaparte, MD, MSc, FRCSC
Ottawa Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

BruiseStick and BruiseFighter

BruiseStick ointment and BruiseFighter help reduce bruising and inflammation with injectables. Refrain from alcohol, green tea, fish oils, NSAIDS for a week before.

Hratch Karamanoukian, MD, FACS
Buffalo General Surgeon
4.9 out of 5 stars 38 reviews

Preventing Restylane Bruising

The number one reason for bruising is improper technique so ensure that you are going to an experienced and expert injector. Avoid aspirin and herbal supplements prior to the treatment. Arnica can also be helpful. Alcohol should be minimized. No heavy exercise post treatment.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 38 reviews

Minimizing bruising

Make sure you stop all aspirin base, anti-inflammatory products, and fish oil a week or two prior to injecting. Also there are some homeopathic supplements out there such as Arnice Montana, Arnica Forte or Sinnech. And most physicians will give you some ice to apply after your treatment.

Bruce E. Katz, MD
New York Dermatologic Surgeon
3.8 out of 5 stars 17 reviews

Can bruising from Injections be avoided?

While the possibility of bruising can never be completely eliminated, there are ways to limit the possibility.

  • Do not take aspiring or ibuprofen for a week before treatments.
  • Do not take fish oil supplements for a week before treatments.
  • Choose a practitioner that is very experienced as injectors tend to have less bruising incidents as they become more experienced.
  • As a backup plan, choose a practitioner that has a Pulsed Dye Laser. We use pulsed dye lasers to remove any bruising from injection procedures within about 48-73 hours of the bruise.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

Preventing bruising after Restylane injections

Bruising can be prevented or minimized by following the guidelines described below:

  • Arnica tablets: BruiseKare; Sinecch, Homeopathic arnica montana
  • Arnica ointment: BruiseStick ointment
  • Massage early
  • Avoid aspirin, ibuprofen, Motrin, Advil, or any other blood thinners
  • Use ice after the injection
  • Massage early
  • Hold pressure immediately after the injection

I recommend Bruisestick ointment stick to all of my patients after injection with Restylane, Botox, and Juvederm.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Minimize bruising

First, patients should avoid any blood thinning medications at lesat 1-2 weeks prior to filler injections. Products like aspirin or non-steroidal anti-inflammatory agents such as motrin should be avoided. Also, some topicals or local anesthetics that contain epinephrine may help minimize bruising. Products with epinephrine constrict blood vessels and can minimize bruising.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 26 reviews

It takes two to tango!

The issue with bruising and injectibles is a common one. Patients nowadays are on aspirin for heart disease prevention as well as multiple supplements to improve their general health. These substances can thin the blood out making the risk of bruising higher. I ask my patients to avoid taking anything other than prescribed medications for two weeks before their injections. I also believe that good careful injection technique will help minimize the bruising. Finally, there is some evidence in the literature that the homeopathic medications Arnica Montana and Bromelain might be effective in decreasing bruising. I don't think it can be eliminated completely.

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 52 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.