Is it normal to have tenderness/pain 72 hours after lip filler? (Photo)

Thank you for your question. You submitted two photos, asking if it’s normal to have pain and tenderness 72 hours after undergoing lip augmentation. You describe having some bruises, so you’ve been applying ice. You are concerned about what to do moving forward.
I can share with you my opinion on what you’re experiencing based on the photos you’ve submitted, in the absence of a physical examination. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Lip augmentation is a very popular procedure in our office, and I’ve gone through my own evolution of developing techniques I find are the most useful, and with minimal trauma to help my patients have nice looking lips, and also want to continue doing these procedures because of their experience.
Just by looking at your photos I would conclude that more than likely your doctor did the procedure, like many doctors do, by injecting filler in multiple points from the outside so different areas of the lip can be improved. Looking at the anatomy of the lips, there is a desire to naturally place the filler in key areas to get a result. It is a very standard approach to use needles to then enter the skin and place fillers. Often this is done with local anesthetic like a dental block to make the lips numb so the patient experiences minimal pain.
That said, it is my preference to do these procedures using blunt cannulas. Although there is always a value of potentially using needles, for example fine lines above the lip, or specific areas that may not be reachable with the cannula, for the overwhelming majority of my patients, I’m placing the filler with minimal entry points. They can look pretty good immediately after, with minimal to no bruising, which is a personal approach and strategy that has been successful for me.
In your situation, what you are experiencing is consistent with a certain degree of trauma with bruising, which is likely to resolve and with minimal intervention. Supportive care using anti-inflammatories and non-steroidals can help the swelling, that is causing most of the discomfort, subside as the days go on.
It’s best for you to speak to your doctor, and I’m sure that if your doctor does this particular approach, they are probably pretty familiar with this swelling, bruising, and tenderness which are a reality with this approach. Not everyone gets that degree of bruising and swelling, so it varies with individuals.
Without overstating, you can consider discussing with your doctor a different approach in the future once this filler eventually breaks down and goes away. Don't abandon hope getting future filler because of this experience. It is important to maintain communication with your doctor,  who I’m sure wants you to have a great result, and probably put in a lot of time to get this result. Aesthetically, I think your lips look really nice. I think it’s just unfortunate that right now there’s enough bruising and swelling that you feel uncomfortable, but it is within the normal range for what I think was the approach used. I hope that was helpful, I wish you the best of luck, and thank you for your question.

While I would not say that it is normal, it certainly is possible to develop swelling, bruising, pain and/or tenderness after a filler injection into the lips.  Normally these issues gradually improve over time.  If you feel there is no improvement after a week or so, you should contact the physician who treated you.   

Thank you for your question. Known side effects of lip fillers are tenderness, bruising and swelling, so it isn’t uncommon that you are experiencing these symptoms. Continue to ice your lips and the swelling and tenderness should resolve on its own in a few more days. Good luck!
Anthony P. Terrasse, MD