Severe Hematoma from Botox

MasonGirl,
I am sorry to see that you had such an experience with Botox. Certainly this is a very rare complication - I personally I have not seen this happen with Botox injections. However, regardless of what is being injected, if a superficial artery or vein is punctured, this is a possible outcome. 8 weeks later is a long time for the bruising to still be present. It sounds like you are doing everything right.
Talk with your doctor about possible referral for further interventions such as ultrasound or laser to help hasten the recovery process. If there is a palpable pocket of fluid, then your surgeon may be able to drain it his or herself for you. I hope this is helpful.
Dr. David Shafer

You experienced an unfortunate situation that is rare but can happen. Continue avoiding medications that encourage bleeding, smoking and drinking alcohol. The bruising will resolve on its own, but it will probably take a few more weeks.

Our office advises patients to use Bruisestick ointment right away if bruising occurs after Botox or Juvederm injections. 

Pulsed-dye lasers and focused IPL treatments work well to expedite the resolution of bruising.  The laser energy targets breaks up the pigment and allows your own body to reabsorb them more quickly.  It's important to seek out a physician experienced and familiar with this indication to achieve the best results.     

One not so well know solution for resolution of bruising from injection procedures is the pulsed dye laser. We use it in our own practice if a patient gets bruised and we often resolve bruises for patients like yourself that have been injected at another practice. There are options besides waiting and you should seek out a physician in your area that has a pulsed dye laser and is familiar with this type of treatment.

Thanks for the question.

As the other physicians have noted, any injection can injure an artery, which can lead to bruising and a hematoma (a collection of blood).

The anatomy of the tear trough area can make the hematoma appear worse. The skin of that area can be very thin and show uneven injections or hematomas more easily and for a longer period.

I know you've given it 8 months, but additional time is your best bet. Try gentle massage in the meantime. A good concealer can make the bruise easier to live with.

I hope this helps.

I would have to wonder if you might have some underlying reason for such severe bruising (taking medications that might lead to "thinnning" of the blood like Aspirin, Ibuprofen, Plavix, Vitamin E, Green Tea, etc). In my 16 year experience with Botox, I have not seen this extent of bruising or swelling after Botox injections. Still, at this point, nothing but time will make much of a difference. It may take another 4-8 weeks before this becomes less apparent.

Any injection has the potential to injure a blood vessel. The larger the vessel is the more bruising there will be.
Because you have had the bruise for a long time, it sounds like it may be located in the tissue in such a way that it is harder for the healing elements to reach it. Think of it as if the bruise is hidden between 2 walls and it takes a while to break the wall down. To speed up the clearance of the bruise you may need pulsed dye laser treatments to "break up" the blood that makes up the bruise.
Whether you have laser treatments or just let it heal on its own over time, you may have a discoloration that can take months to fade. Be sure to avoid the sun and wear sunscreen every day.

Your result is not typical but is a known risk of an injection of any type. The area around the eye is very vascular and therefor blood vessels can be at risk from injections and result in bruising.
Many physiicians require patients to be off any medications that might increase the risk of bruising for 2-4 weeks prior to injections. An example of these products are aspirin type medications or anti-inflammatories like Motrin.
At this point, I would just wait and allow the body to heal. You have already done most of the common treatments for this situation. It certainly can be bothersome to have such a long lasting bruise when you originally wanted to get improvement in lines and wrinkles in that area.

It's unfortunate that you have experienced one of the adverse effects of injectable cosmetic medicine, especially on your first treatment. However, for the reasons previously cited, most importantly possible underlying bleeding disorders, it may be a fortunate complication. I hope it turns out to be simply a bruise for you, which will eventually disappear in time. Keep out of the sun, as it will prolong the discoloration. Good luck!