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Swelling and Bruising after Cosmetic Filler Application is Part of the Normal Healing Process

Thank you for your question. You’ve submitted
some photos and you stated in your question that you had Juvederm on the under eye tear
trough area a week prior, and you have swelling and bruising, and you’re asking if this
is normal. Well, certainly this is a question easily
answered by the doctor who performed the procedure for you, but I’ll share with you a little
bit about my perspective and take this opportunity to maybe provide you with some additional
information that may be helpful. I’m a Board-certified cosmetic surgeon,
and I am a specialist in oculofacial plastic and reconstructive surgery, practicing in
Manhattan and Long Island for over 20 years. Cosmetic and reconstructive procedures of
the eyelids and the face is something we do everyday, and the use of fillers for the tear
trough area is also something that we also do very commonly. It often amuses me, if you will, when patients
who have fillers complain of bruising and swelling a week after a procedure. The reason
why it’s a little ironic is that often people don’t want to have surgery because they’re
concerned about the bruising and swelling after surgery, amongst other things. In fact,
in our practice, we have patients who we’ve done transconjunctival lower eyelid blepharoplasty,
obviously to address the puffy bags under the eyes, which people are looking to treat
non-surgically with fillers, and they can come back after a week and have almost no
bruising or no bruising at all. So the paradox, and why I used the term “amused”, is that
people will avoid surgery and get injectables and still have bruising and swelling. Basically, it’s important to understand,
that a procedure where there’s a needle involved is, by definition, invasive. So it
may not carry the term “surgery”, but it is something where you are getting something
done through the skin and under the skin. Which means that, automatically, you can hit
a vessel or a capillary, and you can get bruising. No doctor is immune from that and it’s important
to factor that in when you have these injectables. Swelling can also be a significant factor,
because of the trauma of doing the treatment. The filler itself, anything in the hyaluronic
acid family, will expand a little bit because of a variety of factors, and because by nature
the material is hydrophilic, which means it likes water, it pulls water in. It can be
swollen as a part of the natural transition period after this injectable is done. Now, for a lot of people, less is more, and
we’ll often do a little bit and see how they do, and then add upon that later on.
We see our patients routinely after two weeks when we do an injectable treatment. Now, with
the photo you submitted, it’s difficult for me to ascertain, but it appears that you
have puffy under eye bags, which may have become accentuated from the injectable. If
you have a significant amount of fat prolapse, it might be worthwhile discussing this with
your doctor, about the possibility of undergoing a cosmetic procedure to address the fat prolapse. As far as the bruising and swelling and the
term “normal” is concerned, the answer is yes, it is normal to have bruising and
swelling a week after the procedure. This is part of the normal healing process, and
so it’s very important that you communicate this with your doctor, and if you haven’t
arranged a follow-up visit, make sure you do that and see your doctor and show the doctor
how you look. As a physician, it is important for me to
see how my patients respond to the way I do a treatment. A lot of times patients come
to us and they state that they had a “bad experience” with name any filler, and often
they feel that the filler was not good for them. I explain that it’s really a combination
for factors. It may be that the filler is too viscous, too thin, whatever it is, but
it’s also a lot to do with technique, and style, and artistry, and approach to doing
this. I always tell my patients that I approach fillers the way I approach surgery—we take
our time, we have a real process, we do it very very methodically. It’s not like a
lot of offices where the doctor will come in, see you for a second and do a quick injection
and the run out. I think the obsessive quest for the ideal result requires time when you’re
doing these things. But that’s a separate issue. Again, I think it’s very important that
you speak with your doctor and discuss how you appear, and I’m sure your doctor will
appreciate the feedback on how you responded, and it will probably help the doctor make
note of what your reaction was or response was with this treatment. The more data, the
more communication, the better. So, I hope that was helpful and I wish you the best of
luck. Thank you for your question.

Cesar Sullivan

4 thoughts on “Swelling and Bruising after Cosmetic Filler Application is Part of the Normal Healing Process

  1. Love your videos! I had bruising that has lasted for over a month on the marionette lines on side of my mouth. Than they gave me a free treatment to breakup the bruises and that has caused skin discoloration. I did not have a Doctor do it, but and injector that was in the top 3%. It was not worth it for me. 🙁 I was so disappointed.

  2. I will be opting for eyebag surgery instead of injectables & I will definitely be looking for a board certified Oculoplastic Surgeon. Thank You for your very clear & precise explanations.

  3. Thanks for this! I just had my tear troughs done, however they do look dark after? I have been told that is bruising? It was a bit of a shock as I expected to see an improvement and when I got home it looked like the tear trough had worsened and that I had 2 black eyes (not upper lids) Is that common?

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