Restylane Injection Hit Blood Vessel in Eye Lid. I Wonder if I Should Look for Another PS?

If you were not prepared for the possibility of getting a black eye with your undereye filler treatment, then I seriously question how "experienced" your plastic surgeon really is.  This service cannot be done without causing lower eyelid bruising in a percentage of all patient's treated even if they stop taking their Tibetian yak liver supplements or whatever.  Simply the treatment has to be placed behind and in the lower eyelid orbicularis oculi muscle which is quite vascular.  I have one of the largest practices of lower eyelid filler treatment in Los Angeles. In assessing the total experience, 30% of individuals have some type of lower eyelid bruise and 2% get a black eye.  A small bruise at the point the needle was injected might easily hid under coverup.  A big black eye that looks to the world like you were slugged by your domestic partner (and that is what the world will think) is just never going to hide except behind an oversized pair of Gucci sunglasses.  Oh, and this bruise can take 3 weeks to disappear so forget the party you were hoping to look fabulous for this weekend.  No experienced injector would do this treatment without preparing you for this possibility.  I tell my patients that the results are better than surgery but this service is very much like surgery in a syringe.  You get a fantastic result that rivals or is better than surgery without going to the operating room and it is basically painless and it is all done in the office.  The down side is yes, you can bruise and the treatment may need adjustment once it has settled.

Should you throw in the towel on your "experienced" plastic surgeon.  Hey this was a big detail to leave out.  As you say, anyone can cause a bruise.  It is the lack of preparation that is at issue here.  I recommend that you let the dust settle which will be about 10 days after all of the bruise has disappeared.  If the result is great, perhaps you can forgive.  If there are issues with the treatment, then it might be a sign to move on.

In our practice, we see probably 1-2 out of 10 patients with bruising under the eye after Restylane injection to this area.  Usually it doesn't start until 1-2 days later though it can begin immediately.  The results in this area with Restylane are phenomenal if done correctly but we do caution our patients that the area under the eye can bruise more easily than any other part of the face (second to the corner of the lips) so we always ask if they have any big plans in the coming days before injecting.  Since this complication can occur in the most able hands, if you like your PS and he's done a good job for you in the past, stick with him.  Those pesky veins are just hard to avoid sometimes.

the risk of bruising is usually discussed with patients prior to injecting the lower eyelids (and other facial areas, but especially the eyelids since the skin is so thin and more vascular there), but ice prior to and even after does not  minimize bruising (it may make the injection more comfortable and may decrease post injection swelling). Your makeup may not hide it well but there are many coverup makeups and experts to help you.  Warm compresses, V-beam laser, topical vitamin K such as Auriderm, and Arnica by mouth, may help quicken the resolution of your bruise, but you should check with your PS.