How Should I Deal with Bumps and Bruises After Restylane?

J.J.,
Injections around the eyes should always be done by someone with extensive injection experience. However, even with experienced injectors, you may get a bump or lump. This may be due to the injected material, a reaction to the material, a bruise, or just swelling.
If the area does not smooth out over a few weeks, then it may be necessary to inject the area with a special medication (hyaluronidase) which will help dissolve the product. The hyaluronidase breaks apart the hyaluronic acid which is found in Restylane and Juvederm products.
Good luck and hopefully you will have a nice trip abroad.

Bruising and swelling is possible after any filler injection, including Restylane. Some of this can be minimized through certain techniques, but in some cases may be unavoidable.
As with any post-procedure problem, the first step is to contact the provider who performed the procedure.
For bruising that has already developed after fillers, time is the most important factor, as most bruises simply take time to resolve. The supplement Arnica is sometimes recommended to speed bruising resolution.
For swelling, ice packs immediately after injection can be helpful, and keeping the head elevated at night can also be beneficial.
For nodularity or irregularities, sometimes gentle massage can help to smooth out irregularities, but this should be performed under the guidance of your injector. In most cases, irregularities will also smooth out with time.
All the best,

In the vast majority of patients who undergo lower eyelid
Restylane injections, the results are excellent. Unfortunately, we occasionally
see patients who develop lumps, bumps and eyelid discoloration following these
procedures. These findings are often associated with bruising as well. This
area appears to be susceptible to this type of problem, because of its complex
anatomy and the thinness of the overlying skin.Although,
these problems may be related to swelling in the early post injection period,
after two weeks they are more likely related to uneven distribution of
Restylane. In the first 48 hours following treatment uneven Restylane can often
be corrected with massage of the lower eyelid. After two weeks more aggressive
treatment is usually indicated. In most cases, this requires injection with the
enzyme hyaluronidase.The
best way to address bleeding and bruising following Restylane injections is to
prevent it from happening. Avoidance of Aspirin, Ibuprofen, Motrin. Aleve and
other drugs that cause bleeding is important. Ice compresses pre and post
injection can also decrease the incidence of bruising. Once bruising has
occurred it resolves on its own over the course of 10 to 14 days.It’s
important to discuss these issues with your plastic surgeon. Your surgeon
should be able to address these issues and alleviate your anxiety regarding
these problems.

Thanks for the question. 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?I go over alot of information so hopefully it helps in the future!James P. Bonaparte, MD, MSc, FRCSCHead and Neck Surgerypracticing in Facial Plastic and Reconstructive SurgeryAssistant Professor, University of OttawaOttawa, Ontario, Canada

I advise my patients to begin treatment with Bruisestick ointment after injections to minimize bruising and swelling after a procedure. Raffy Karamanoukian Los Angeles

Thank you for the question -- don't lose hope! Injections around the eyes always cause a certain amount of bruising and swelling. Generally, this resolves over the course of 3 to 5 days. Ice-cold compresses to the area can be very helpful, as is avoiding strenuous activity and blood-thinning medications.  Bumps are a different story. These generally result when the product is placed too close the skin surface. In the lower eyelid, filler (I use only Restylane here) needs to be placed underneath the thin muscle layer.  If some filler is placed between the muscle and the skin, or even in the very delicate eyelid skin, bumps will result. These need to be treated with an enzyme to dissolve the filler. I would recommend close follow up with your surgeon and/or seeking a second opinion. Best of luck!
 

the bumps may be gone in a few days, but if they persist longer they can be injected by hyaluronidase which dissolves the product. If the bump is related to bleeding under the skin it will be gone on its own most of the time, but warm compresses may hasten its resolution, as they can improve the bruising.

First, let's discuss options for fixing the current problems.

Hyaluronidase is an enzyme that can be injected immediately if the bumps cannot be resolved by massaging the product. This enzyme will break down the product and get rid of the bumps. Ask your injector about this option.
Pulsed dye lasers are used in our practice to remove bruises from injections. We do not agree that all injection bruises will usually go away after a week and have seen patients with bruises 1-2 months after being injected at another practice.

As for the issue of if and when you have "tear trough" or under eye injections again...the other practitioners are right that this is a very sensitive area and one where excellent technique is important. Normally, to avoid under eye bumps a technique where the product is injected "under the muscle" is used. Ask your injector which technique was used for you and if he/she is not injecting under the muscle, look for another practitioner that is VERY experienced with this procedure.
Bruising can occur in any injection patient so this is harder to avoid, but using a practitioner that has a pulsed dye laser to reverse the bruising will mitigate your risk of having a big issue with bruising.

Restylane under the eyes can leave bumps which typically are small collections of Restylane secondary to the very thin nature of the under eye skin.
Bruising typically will resolve on its own. The bumps may not. Your treating physician can treat these with Hyaluronidase. However you may still have some unevenness that only time will fix.
I hope this helps.

The lower lid skin is the thinnest skin in the body and placement of filler there must be done carefully to avoid exactly what has happened. Massage in this area works well. What you are trying to do is spread or flatten the product by pressing it against the bone with the pad of your finger. If you are unable to do this on your own, you should return to the physician who placed this so that he may help you.
If massage fails than and you are unable to achieve a good contour, I would inject hyaluronidase to dissolve the product. Your appearance at this long awaited event is more important right now than the money you spent on this product. At least there is a simple solution to this problem.
I wish you good luck