Skin necrosis or bruise below lower lip? (Photos)

Question

Hello everyone A few hours ago I had juvederm inject.on top and bottom lips, it was the second shot(the doc kept the syringe for me for a week)so he injected very little on both sides. After 4 hours I noticed a bluish spot below the site of inj.that wasn't there before and now after 12 hours is slighly bigger and the colour is more intense than before. Is it normal that the bruise becomes bigger after 10 hours? Called the doctor he said it's normal don't go to the hospital.

Martin Jugenburg, MD · Answer

The lips are very vascular and bruising is quite common in this area.  Because of the vascularity of the lips there is a high risk of intravascular injection.  If you are concerned at all about pending necrosis see your physician right away.

Jason Emer, MD · Answer

If you are confused or worried please see your physician.  Its likely just a bruise but no reason that you cannot be seen to ensure this is not an issue.  Best, Dr. Emer.

Nelson Castillo, MD · Answer

Thank you for your question and for sharing your photographs.  This appears to be a bruise from your injections and not skin necrosis.  Bruising can worsen in the first 24-48 hours after treatment so do not be alarmed.  This should resolve spontaneously over a week's time but you can try to accelerate the process with cold compresses, sleeping with your head elevated at night with a couple of extra pillows behind your back and arnica/Bromelain supplements. Hope this helps.

T.G. Khan, DO, FACS · Answer

This is likely a bruise - the lip area is very vascular and bruising is not uncommon. However, please see your Dr. ASAP to rule out any more serious concerns that you obviously have.

Millicent Odunze Geers, MD, MPH · Answer

The photo appears to demonstrate bruising. Bruising can become worse before it gets better. You were correct to relate your concerns to your doctor. Consider using cool compresses as well as arnica and bromelain pills to help hasten your healing process. Best of luck.

Christian N. Ford, MD · Answer

Thank you for your question and for sharing your photographs.  Sorry that you are having some concerns about your postprocedure appearance.  Please keep in mind that it will take 2 weeks to see your final result.  Swelling and bruising after filler injection is normal, especially in the lips.  Icing can help for up to 48 hours postprocedure.  Arnica can also help to minimize postprocedure swelling and bruising.  Gentle massage may be beneficial.  In general, after lip augmentation with fillers, it will take 2 weeks to allow for normal postprocedure swelling and bruising to resolve and to see your final result.  Hope this helps and if you continue to have any concerns, please be sure to see an experienced injector for an in-person reevaluation in order to best address your concerns and to determine the best course of action.  Best wishes!

Skin necrosis or bruise below lower lip? (Photos)

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