Icing Before and After Juvederm for Swelling and Bruising?

Question

Should my plastic surgeon be applying ice pre and post procedure to help minimize swelling and bruising? I just had it done and have horrific bruising.....no ice, numbing cream or local was used in my procedure. Please advise!!

Young R. Cho, MD, PhD · Answer

Thank you for your question and for sharing your experience. Icing during and after the procedure definitely helps with swelling reduction. If you feel swollen, then I would continue to ice on and off for 5 to 10 minutes every hour for the first day or two.

Michael Constantin Gartner, DO · Answer

Cold compresses can help prep the area and numbing cream can also help. However, Juvederm has lidocaine in it so it's not totally necessary. I have treated patients using nothing and bruising has been minimal.  But since you are now in the post-treatment period, you can definitely apply a cold compress to help with the swelling and bruising. Apply a few minutes three times a day or so, keep your head elevated and avoid medications like aspirin that can make bruising worse.

Jerome Edelstein, MD · Answer

I would recommend using arnica gel, which is a herbal remedy that can help to minimize bruising.You can also use a a bag of frozen peas, placing it on the area for 15-20 minutes at a time for about 3 or 4 times a day.

Raffy Karamanoukian, MD, FACS · Answer

Bruising can occur after Juvederm injections. Our office ameliorates the risk by prescribing Bruisestick ointment to the area after injection. Bruisestick contains both Arnica and Bromelain.

Paul L. Leong, MD, FACS · Answer

Not all doctors follow the same protocol before
injections, but the goal should be to make the patient as comfortable as
possible, with the least amount of bruising or swelling. Some people tend to bruise easier than others
but there are some things you can do to reduce your chances of bruising.
1.) Ice the area
before and after the procedure. (This
can also help reduce pain).2.) Avoid blood
thinning medications one week before and after treatment.Ibuprofen, Aspirin, Vitamin E, Fish Oil and
Alcohol are some common blood thinning agents 3.) Find a doctor who
injects using microcannulas .A
microcannula is a needle with a rounded tip that reduces the likelihood of
bruising.4.) Try taking Arnica
or Bromelain capsules. Some patients
have found these products useful in reducing bruising, though definitive
data supporting the use of these
products is not complete.I hope this information helps!

Benjamin Barankin, MD, FRCPC · Answer

Ice can be helpful to reduce pain, swelling, and bruising during and/or after the procedure. However, in many cases the physician can tell whether they hit a blood vessel or a bruise may form, and then be more inclined to bring out the ice pack only at that point. If you've had bad bruising in the past, notify your physician and there are many things you can do or avoid to minimize (can't entirely prevent) the risk of bruising.

David C. Mabrie, MD · Answer

The microcannula is easily the biggest advancement in the last 5 years for fillers.  It has the following advantages.:

	
		Less bruising. About 5% of my patients now get bruises after injections.
	
		Less trauma.  The number of injections is much less using a cannula.
	
		Smoother results.  The filler comes out smoothly and the injector has greater control over where the filler is placed.
	
		Improved safety.  Using a microcannula reduces the risk of intra-vascular injection.


	 

	Even with the microcannula, there is a small risk of bruising so it's still important to plan ahead, giving yourself a week in the worse-case-scenario.

	 

	Good luck in your search fro information.

Glenn Vallecillos, MD, FACS · Answer

Laura,

	Thanks for the question. Sorry to hear about the bruising. We recommend people abstain from medications that are conducive to "thinning" of blood and subsequently predispose you to a higher likelihood of bruising. The products include NSAIDs such as ibuprofen, aspirin, and vitamin E. Alcohol should also avoided prior to an injectable filler procedure. We do make it a practice to ice the area of injection, both prior to, and immediately following the injection, with the thought being that the vasoconstriction may aid in diminishing the amount of potential bruising. The good news is that the bruising will subside. Certainly, you may want to consider taking a supplement such as arnica in the peri-procedural period to help aid in the healing process. Best of luck!

Don Mehrabi, MD · Answer

Thanks for your question.

	Bruising is individual, and is also related to the location, technique, medicines, and other factors. Bruising happens when small blood vessels are damaged -- either nicked by the needle going in, or bursting from the pressure of what's injected. The blood in these vessels leaks into the surrounding tissue and leaves you bruised. Certain medicines such as Aspirin, Advil, etc. will cause these damaged vessels to bleed more and lead to greater bruising.

	To minimize this, pre and post icing will definitely help. This will constrict the vessels so that if they are damaged, they won't lead to too much bruising. Avoiding Aspirin and Ibuprofen 1 week before and immediately after your treatment is also a good idea. Firm yet gentle pressure at the site of injection will also limit your bruising.

	Some have advocated Arnica montana as a pre-treatment and post-treatment medicine that will minimize your bruising. The location also has an impact on bruising (e.g. a procedure under or near the eyes has a higher risk of bruising than that on the cheeks / nasolabial folds). On the physician end, a gentle technique with minimal needle sticks will decrease the risk of bruising greatly.

	As you can see, there are many factors that lead to brusing. Try the ice, avoid aspirin, and maybe even do the Arnica. Let your physician know to go slowly. These may all help minimize your bruising. Good luck!

	Good luck!

Thomas Guillot, MD (retired) · Answer

Of course, the most important issue is to avoid medications such as blood thinners, aspirin, Nsaids, and Vitamin E or Omega-3 oils prior to injection. Ice prior to and after injections can be helpful with pain as well as bruising.

Icing Before and After Juvederm for Swelling and Bruising?

Answers (10)

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