Is Juvederm or Radiesse Safe w/ Clotting Disorder?

Expect more downtime with bruising, but if your INR is 2.5 or less, the injections of Radiesse, Restylane and Juvederm are possible.  The former may require a slightly larger diameter needles so the risk of bleeding and a hematoma may be greater, but it is not a large risk.  I would not stop coumadin as the risk of complications would probably be greater as a result of the coumadin cessation compared with complications of injections. Each case though is unique and consultation between your injector and doctor who regulates  your Coumadin may be helpful.
 

It's not the radiesse or the Juvederm that is the problem here...it's the needle!  Patients on coumadin will get a lot of bruising with any injection.  I would not recommend injection treatments while you are taking this medication....

It is always recommended with an injection of any kind that a patient stop taking coumadin or other blood thinners whenever possible.  However, we must weigh in the risk of stopping the blood thinner versus doing the procedure.  Certainly the risk of bleeding, as far as damaging the structures, is much less in the naso-labial fold than around the eye. But many doctors feel running the risk of anticoagulation is not worth it.  What we often tell patients who are very motivated to have correction with an injectible agent is to try a very small amount of treatment with the understanding that they may get a significant bruise.  This way they do not commit to a lot of treatment with a lot of needle sticks right away.  Also, sometimes applying ice to the injected area or using epinephrine in the material that’s being injected can help to reduce bleeding. 

Any injectable procedure may be complicated by a clotting disorder. It would be necessary to know the type of clotting disorder in question. Addressing Coumadin specifically, patient’s underlying problem will determine the amount of anticoagulant effect necessary. The patient’s physician determines the optimal Coumadin dose based on the underlying need for anti coagulation. With increasing risk of bruising, hematoma formation and the increased risk of dermal or subcutaneous bleeding necessitating hemostasis. Any injury such as the use of needles can induce problematic, but probably not dangerous, bleeding. There is nothing inherent in Juvederm or Radiesse that would cause complications in a Coumadin patient; rather, it is the production of trauma with the needle that bares potential complications. It is also advisable to discuss this with your hematologist.

Lizzie

You can proceed with injections of fillers while on Coumadin if you and your provider take some careful steps to minimize the risks of complications:


have your INR checked prior to the procedure

be sure to discuss your condition with a physician, I would not recommend treatment at a spa or mall type facility- you need the expertise of professional 

I also recommend ice before and after, and avoid any activity for 3-4 days after

Be ready to accept bruising despite these measures. The best time would be when you do not have any special events in the immediate future after your injection, though there is no danger in using makeup after. 


Best of luck

It is important that your physician is aware of your clotting disorder and your medication profile prior to treatment.  Although it is not an absolute contraindication to have fillers done while on coumadin or other blood thinners such as Plavix, your physician should use the safest measures to prevent as much bruising as possible. Just be prepared to bruise and do not undergo any of these procedures if you have an important event (wedding, work event) within the following 2 weeks. 

I generally tell my patients that there is always a chance of bruising with filler injections, but I do reduce this likelihood by pretreating those at a higher bruising risk with a topical anesthetic cream that has a vasconstrictor formulated within the product as well.  I then place adequate ice compresses to the area for approximatley 3 minutes prior to injection.  Lastly, I will use Juvederm premixed wtih Lidocaine and Epinephrine to allow for the most optimal prevention of bruising in selected patients.

Hope this helps and good luck.

If you are taking a blood thinner, certainly the risk of bruising is significantly higher.  There may be some oozing after injections as well.  But this is not a contraindication for injections.  Icing the area prior to and after injections does help.

We perform skin surgery of all sorts on patients who take blood thinners.  Discontinuing a blood thinner like coumadin carries a much greater risk of an adverse event than the amount of bleeding from a skin surgical procedure.

For a cosmetic procedure, you do have to be prepared that there may be more bruising.  Make sure your doctor is aware that you are taking coumadin, and make sure the doctor that does the injections is a board certified dermatologist or plastic surgeon with training and experience injecting dermal fillers.

Although a complete history and exam is always needed prior to any procedures, it's usually permissible to have facial fillers even if you're on blood thinners.  These medicines will most likely lead to increased bruising, but provided you go to a skilled injector, there shouldn't be any safety concerns.  Good luck!

People on Coumadin generally are at higher risk of bruising/bleeding even with minor procedures such as the injection of fillers.  If you elect to have a filler procedure, it is suggested that your INR level be checked, to ensure that it is not too high (between 2.0 and 3.0 and preferably closer to 2.0), to minimize the bleeding risk.

I have treated patients that are on Plavix and bllod thinners. They have to be aware that they will definitely bruise more than patients not taking these medications.