How to Reduce Swelling and Bruises on Lips After Restylane?

I have had Restylane injections in my lips yesterday, it is still very much swollen and bruised. How long will this last?

I look terrible, and am very worried about going out in public. It has been almost 24hrs since the treatment and I see no reduction in swelling. Is there a way to speed up the reduction of swelling?

Doctor Answers 42

Side Effects- Restylane injected into lips

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Lips are one of the most sensitive areas to inject with Hyaluronic Acid. Swelling tends to last a few days after treatment to where bruising can last 7 to 10 days. Swelling of the lips tends to be the worst in the first 48 hours after you inject them.   Ice can help to reduce swelling post procedure- try to ice as much as you can.  Also, for future reference you may want to consider Arnica tablets 5 days prior to your procedure- this will help to significantly reduce swelling and bruising. 
If the swelling is severe, some dermatologists may use low dose prednisone for about 3 days to reduce swelling.
The good news is that Restylane works, and its safety record has been clinically documented and supported by robust clinical studies spanning over 10 years. Furthermore, since 1996, over seven million Restylane treatments have been successfully performed worldwide. Restylane is one of the most tried and tested dermal fillers and is recognized as the benchmark for safety.

Virginia Dermatologic Surgeon

Bruising & Swelling with Restylane - Prevention and Intervention

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Using cosmetic dermal fillers in the mouth area can lead to a very pleasing outcome. However, bruising is not uncommon. We believe in educating patients prior to their treatments on things they can do, or not do, to help minimize or avoid bruising. Not only can bruising in the mouth be a problem, but swelling as well. Check with your physician or the link below to find helpful hints to prepare you for an injection treatment. If the bruising/swelling already occurred, below are some suggestions:

*Avoid massaging after injections because this can lead to more swelling or even lead to delayed bruising.

*Cold compresses such as frozen pea bags are very helpful within the first 48 hours - intermittent icing.

*Notify your practitioner of your condition so that they may be made aware and have an opportunity to make suggestions.

*Contact your practitioner if the swelling is not progressively resolving and/or it is getting progressively worse.

*Early intervention goes a long ways in minimizing this response. Make certain that your injector uses a slow, gentle technique, provides icing throughout the procedure for comfort and to minimize bruising/swelling.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Swelling and bruising common after lip filler

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The amount of bruising and swelling in your photo looks normal for 24 hours after filler injection of the lips.  If you are uncomfortable, call your physician.  Excessive swelling can be reduced with oral steroids (prednisone) and/or diuretic (hydrochlorthiazide) but note that oral medications can always have their own side effects so review those with your doctor and her staff.  

Note that bruising and swelling has more to do with you than with the product.  Anytime a needle is injected into the skin there is the chance of bruising. And swelling is especially common in the highly vascular and soft lips. Swelling and bruising can sometimes be reduced by using a cannula for injection but a needle is required to introduce the cannula also.  To reduce the amount of bruising you experience, avoid anticoagulants the week prior to your appointment. Anticoagulants (things that block clotting) include aspirin, non-steroidal anti-inflammatories (like ibuprofen, naproxyn), alcohol, st johns wort, gingko, garlic pills, ginseng.  Some patients find that taking oral arnica or bromelain (also in pineapple) starting a few days before or the day of the appointment helps also.  Using ice after the injection for up to two days can reduce bruising and swelling.  Finally, if you have a very dark bruise, ask your physician about returning for a treatment with a vascular laser like the vbeam which can cut the time it takes for the bruise to go away by half.

I hope this answer was helpful. Best wishes.

Heidi A. Waldorf, MD
New York Dermatologist
5.0 out of 5 stars 10 reviews

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How to effectively reduce bruising and swelling after injectables

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Bruising after Restylane occurs when the needle hits tiny blood vessels hidden underneath the patient’s skin, and swelling is the body’s natural response to an injury - in this case, by the needle. It’s important to note that, no matter how experienced an injector may be, there is always the potential for bruising and swelling - however, to an extent, the amount of bruising and swelling seen can be minimized through appropriate pre- and post-treatment instruction.

As one example, if they wish, patients may be instructed to begin taking Arnica - shown to decrease such effects as bruising - internally prior to their appointment. It is also advised that patients avoid any food, drink, supplement or medication that can thin the blood a few days prior to their appointment, as these can increase the severity of bruising.

After treatment, diligent patients should continue to avoid blood thinners and physical activity. Intermittent icing will help to reduce swelling dramatically within the first 24 to 48 hours. If swelling is experienced, it is likely to peak on the second to third day after treatment before it begins to go down. Bruising can last anywhere from seven to 10 days.

Timing is important. I always advise my patients to plan their treatments in advance of any event or outing. This means that they should not be getting injectables done the day before their wedding or a big photo shoot because, while I will do my best as an injector to ensure they do not experience severe bruising and swelling, it is always a possibility when a needle is being used.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 114 reviews

Prepare for swelling after lip injections -

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Your response is very normal and expected.  The lips swell from the trauma of the injection, as well as from the bruising and the product.  The swelling usually peaks within 24 hours and then starts to go down over the next several days.  It can take more than a week for all the swelling to go away.

You can speed things along by sleeping on several pillows and keeping your head elevated.  Also, after your next lip injection, icing the lips will keep them from swelling quite as much. 

Lip swelling after HA

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I'm sorry to hear you are having a difficult time after your treatment. 

Lips are definitely an area that are  prone to bruising and swelling. The good news is that it  will all settle down in the next few days.

There are some technical things that can be done to minimise swelling at the time of injection such as  cold compresses pre treatment, careful injection technique and cold compresses immediately after your treatment. 

Unfortunately you cant turn back time, so if these things weren't done at the time of your treatment that may explain why you have experienced so much swelling. 

The things you can do now are to  gently ice the area, as well as avoid any vigorous activity. Some people find that topical Arnica is helpful too. It would be worth trying for you to get through this period. 

Aside from those measures, lipstick and makeup can help camouflage the swelling.

I hope everything settles down soon for you.  

Best wishes


Useful approach to help with the swelling

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Usually the swelling after fillers can last up to three days. Placing ice on the area will help a lot with the inflammation. If the swelling is really bad and is not getting any better, you can try medrol dosepak also known as  methylprednisolone, a steroid that in  a lot of cases helps speed up the healing process. You should obtain a consultation with your doctor so he/she can give you the prescription for this strong anti-inflammatory medication. 

Swelling and bruising after Restylane

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Swelling and bruising of the lips after filler injections is not uncommon. Most patients will get some degree of swelling, which is often worse the day after injections. Bruising is less common, but still occurs. Unfortunately, swelling and bruising just take time to resolve. The bruising should improve and eventually resolve over 1-2 weeks. The swelling will typically resolve much faster - within the first 2-3 days this should show significant improvement. Makeup can be applied to help minimize the appearance of bruising.

Certain injection techniques can help to minimize bruising and swelling. Cold packs immediately after treatment can also be helpful to reduce bruising and swelling. Arnica and Bromelain supplements can sometimes be helpful as well. Finally, sleeping with the head elevated can help to speed the recovery process, particularly when it comes to swelling.

All the best,

Matthew Richardson, MD
Frisco Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Lip Injections

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Any time that you are injected you are at risk for temporary bruising and swelling for up to 7-10 days.  We recommend that our patients ice as much as possible post injection.  Sleeping slightly elevated will help reduce some of the swelling as well.  In some cases when there is significant swelling we prescribe our patients a low-dose steroid to help reduce the amount of swelling more quickly.  As for the bruising we recommend Arnica and time.  The good news is the downtime isn't too bad considering the months you will get to enjoy the results of your filler.  If you have questions or concerns it is always a good idea to contact your provider as I am sure they will be happy to help ease your concerns.

Hannah Vargas, MD
Kansas City Facial Plastic Surgeon
4.8 out of 5 stars 48 reviews

Tips to Minimise Swelling & Bruising

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Hi Oz_GR!

The lips are a great area to treat with dermal filler, but are prone to bruising and swelling because they are so vascular (they have lots of blood vessels - that's why they look pink!). Much of what can be done to minimise the risk of swelling and bruising is done before and during the treatment, including:

  • Optimising medication: Discussion with your doctor about your regular medications and supplements is vital. In some instances certain medications or supplements that predispose you to bruising can be safely stopped prior to treatment (though be sure not to stop any without your doctor's advice!).
  • Cold-compress prior to treatment: Placing a cold-compress on the lips prior to treatment helps to 'shrink' the blood vessels down, reducing the risk of bruising.
  • Careful injection technique: Swelling and bruising result from the disruption of tissue by the needle. Whilst swelling and bruising may still occur, good injection technique can minimise how much swelling and bruising occurs.
  • Cold-compress following treatment [Controversial]: Cooling the lips immediately following the procedure, and then intermittently for the next 24 hours will reduce any swelling and possibly bruising. Recent evidence, however, has shown that this rapid cooling may have a negative effect on the characteristics of the injected product - to the point where some manufacturers' instructions warn against the use of ice post-procedure. Speak with your treating practitioner for further information and guidance on this point.
  • Avoiding vigorous exercise, heat or alcohol: Avoiding vigorous exercise, alcohol or extremes of heat (eg; sauna) for 24-48 hours post treatment will prevent the worsening of any swelling & bruising present.
  • Sleeping with an elevated head: For 24-48 hours post treatment, sleeping propped up on 2-3 pillows reduces what is called dependent swelling - basically swelling encouraged by gravity.

Hopefully some of these points help, and I wish you a speedy recovery to your new, full lips!

All the best,

Dr Scott.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.