Lump, Swelling and Bruising After Botox

Question

I had botox done 2 days ago and I he hit a blood vessel causing a nickel size lump that he said would go away in 2 hours. It never went away though I iced it all day long. it shifted to under the eye and the whole area swelled up and bruised. it is day 3. He said it would go away in a couple days but it is worse. Do I need to go to a doctor (i dont have medical insurance) or will it go away on it's own and what can I do to help it heal quicker. I am scared as my job is dependant on my looks

Otto Joseph Placik, MD · Answer

As long as the swelling has stopped and there are no signs of increasing pain, redness, or visual difficulty, then your bruise will resolve. In some cases this may take as long as 3-4 weeks but typically by 7-10 days 95% have resolved.

Rupert Critchley, MD, MRCGP · Answer

Hi there!
Thank you for your query. Swelling and bruising can certainly be a common side effect after Botox treatment which is the case with any needle under the skin (around 1 in 10). If this occurs expect it to last 7-10 days. I recommend my clients wait 2 weeks before coming to clinic for a review. This is to allow enough time for the initial swelling to subside and for the full effects of the Botox to be visible.
Ice / cold compress is useful in the first 48hours. Arnica may also play an anti-inflammatory effect. Paracetamol is recommended if there is any discomfort.
Hope this helps!
Best Wishes,
Dr. Rupert

Young R. Cho, MD, PhD · Answer

Bruising after Botox can occur.  Most of the time it is visible the same day or the very next day.  In some cases, however, it may become visible several days later.  A bruise occurs when blood leaks out of a traumatized blood vessel. It could be that with strenuous activity or rubbing or due to blood thinners that an injured blood vessel dislodges a clot and causes some blood to leak into the tissue and thus cause a visible bruise (e.g. heavy exercise a few days later may results in a bruise).   The bruise typically dissipates within a week or two.

Michael Constantin Gartner, DO · Answer

It will go away eventually, and it usually takes about a week or two. I'm sorry to hear that this happened but fortunately, you'll notice it disappear gradually. Arnica supplements may help, and avoid smoking, drinking and taking medications that encourage bleeding (like ibuprofen and aspirin).

Jerome Edelstein, MD · Answer

Swelling and bruising are common after Botox. To minimize these temporary effects, apply a cool compress. You may also want to consider stopping any medications that thin the blood for about a week before your treatment to minimize bruising. These medications include aspirin, ibuprofen and St. John's Wort.

Ron Shelton, MD · Answer

if the lump is a collection of blood, a hematoma, from injecting a blood vessel inadvertently, then it has a good chance of resolving by itself. some hematomas can dissolve faster by using warm compresses. Contact the doctor who injected the Botox to ask advice.

Anna Hemming, MBChB, BSc, MRCGP · Answer

Luckily there are not many serious side effects from botox treatment and although frustrating for both the patient and the doctor swelling, redness, and bruising can happen. If a larger vein is punctured by the needle then there will be more bleeding. Pressure, icing and a product like Bruise MD gel can be applied. Often the bruise can be contained and stopped in its tracks. If further bleeding occurs internally the blood can cause a small haematoma which takes longer to resolve. 
In the eye area the bleeding collects and then drops to the lowest and loosest area of skin under the eye. This can give the appearance of a black eye but should be able to conceal it with makeup.
Bruising is not a significant issue and should resolve in a few days, slow metabolisers may last longer and a larger haematoma can take 3-4 weeks to fully resolve. If you have any visual changes, tenderness or increasing pain please seek medical advice from you physician.
If you are at all concerned about the after care or effect of your treatment you should return to the doctor providing your treatment. Always see a fully qualified medical doctor for your aesthetic treatments.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question and for sharing your photograph Bucky.poo. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids as described above. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.Please consult with a doctor for specific recommendations. Good luck!

Heidi A. Waldorf, MD · Answer

Even if everything is done right, any time a needle hits the skin, there is a chance of a bruise.  Icing and pressure right after can help limit the bruise, but there is no guarantee it will stop it from forming.  Once the bruise is there, your choice is to wait it out (can be a week or more) or to see your dermatologist for Vbeam treatment of the bruise itself.  That can shorten the time to resolution from weeks to days.  In the meantime, get a good coverup makeup:  Kat von D concealer, Dermablend, and Cover Fx are three that tend to work well.  The key to concealer is to apply it like spackle -- tap it on rather than sweeping or rubbing it in.  That way you can layer for better coverage.  And tell people at work that you hit your head on a cabinet.  No one will be the wiser.I hope that helps answer your question.  Best wishes.

Hardik Soni, MD · Answer

Bruising after Botox can occur. Most of the time it is visible the same day or the very next day. In some cases, however, it may become visible several days later. A bruise occurs when blood leaks out of a traumatized blood vessel. It could be that with strenuous activity or rubbing or due to blood thinners that an injured blood vessel dislodges a clot and causes some blood to leak into the tissue and thus cause a visible bruise. The bruise typically dissipates within a week or two. Swelling, redness, discomfort and possibly bruising during the first few days following the injection is common. Most of this settles down within 3 days. Occasionally, the swelling can last up to one week, as well as bruising. As long as the swelling has stopped and there are no signs of increasing pain, redness, or visual difficulty, then your bruise will resolve. In some cases this may take as long as 3-4 weeks but typically by 7-10 days 95% have resolved.

Lump, Swelling and Bruising After Botox

Answers (16)

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