Juvederm in Nasolabial folds - vertical visible "worm-like" line and bruising. (photos)

Question

I had Juvederm done yesterday.Doctor used only half a syringe,as she saw I started bruising right away. I was told to come back in a week to see the results and adjust/add of what is left. I see a lot of bruising on one side and a vertical line on the other.I read Juvederm should be injected from lower to upper part.But doctor used a top to bottom approach.Does my doctor use the right technique? Should I dissolve the filler and look for another doctor?Will I get rid of this visible line?

Jason Emer, MD · Answer

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting,  and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Michele S. Green, MD · Answer

I would definitely return to your treating physician to have V-Beam for this bruise.  This is not the injection technique that I use. Hopefully the results will be effective and you will like the end result. Please keep us posted.  Best, Dr. Green

Steven Wallach, MD · Answer

Bruising can happen with any injector. I may be related to medications your are taking too like NSAID's or Aspirin.

Faiyaaz Kalimullah, MD, FAAD · Answer

Thank you for your question and for submitting your photos.  There are a variety of techniques used to inject the nasolabial folds (NLF) - I personally inject from the top the the bottom for most patients, but I have also seen many injectors inject from the bottom to the top.  Unfortunately, some of the most common side effects of cosmetic injections are swelling and bruising.  I often prefer to use a blunt cannula in the NLFs rather than a sharp needle to minimize the risk of bruising.  Furthermore, Juvederm itself can feel hard or rope-like initially after injection - over the course of a few weeks, the filler should absorb water and gradually soften and blend into your skin.  I would recommend scheduling a follow-up appointment with your doctor to discuss your concerns.  There are lasers that can be used to help bruising fade faster - in our clinic, we offer this service complimentary to any of our filler patients who experience bruising after treatment.  Your doctor should also be able to massage the Juvederm, if needed, to help it better blend into your skin.  Best of luck!

Leonard Grossman, MD · Answer

Juvederm can be injected in many ways and every way is correct if the outcome is good. 
Looks like you have a bruise and it's a bit difficult to tell if you have anything more than that. I would have you treating doctor look at you sooner. 
Good luck from NYC.

Rebecca Baxt, MD · Answer

most doctors do a top to bottom approach to inject juvederm on the folds but it can be done bottom to top also both are fine. Any filler or needle can cause bruising which is annoying but true. If there is bumpiness it should be able to be massaged out most likely. Please ask your injector. When we have bruising we offer free pulsed dye laser treatment to our patients to minimize it. Some patients like arnica to reduce  bruising

Juvederm in Nasolabial folds - vertical visible "worm-like" line and bruising. (photos)

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