New York City Fillers - Related FAQ's

I saw a photograph on the internet of a face that was all discolored red and purple, on one side of the cheek after she had a filler injected. It looked terrible. Is this common?

Bruising can occur, in small areas, but occasionally, with the thicker fillers and volumizers that are meant to be injected more deeply, bruising can be significant. One should try not to have fillers done, even if you have had many sessions of it in the past never receiving a bruise, to soon before an important social function, because “Murphy’s Law” may prevail and this could be the first time you get a nasty bruise. Avoid aspirin for 10 days to two weeks before injections, avoid the non-steroidal anti-inflammatory medications such as Motrin, Advil, Ibuprofen, Alleve, Arthrotec and other blood thinners such as garlic tablets, ginko biloba, ginseng, vitamin E (supplements, the amount in a multivitamin does not cause problems for most people) and fish oil for at least two days prior, if not a week. Don’t exercise that day after the procedure. Keep your head elevated (no bending at the waist) but you can bend your head down to read and type. Some concealers, either green or yellow, can convert the purple like color of a bruise to a brown color which can then be hidden more readily by your foundation and makeup. Sometimes, more of a camouflage makeup is needed such as Dermablend or Covermark, and occasionally, a professional makeup specialist should be consulted to help you cover the spots. The bruises should be gone on the face by two weeks. Warm compresses, for about 5 minutes three times per day can help expedite the bruise but only start these the day after the injections. Some vitamin K creams may help more than others to decrease the bruising. V-beam laser treatments have been shown to help diminish the life of the bruise by several days.

The bruising you saw on the internet may be related to a rare complication of blood vessel flow compromise by the filler compressing the vessel or being injected into the vessel itself. The neighboring skin then becomes inadequately supplied with blood and oxygen or there is an impeding of blood flow return. The surrounding skin can become very mottled and dark. This often happens very quickly and the doctor, and the doctor may give you some medicine by mouth or topically or both to help. If a filler such as Restylane or Juvederm was used, then hyaluronidase can be injected to help dissolve the product. This is not helpful if Radiesse, Sculptra or Fat injections were given. Fortunately the color of that skin usually returns to normal but can take many weeks for it to resolve. Use sunscreen and follow-up with your physician regulary to ensure the skin is improving. I had fat injections done to lift my cheek about four weeks ago but I have persistent tenderness in the middle of the cheek and numbness of the lower eyelid and upper lip on the same side. Will this go away?

You may have a slight inflammation of a sensory nerve which can transmit pain along the nerve’s pathway. This may go away on its own but you should see your doctor to evaluate the symptoms and determine if medical treatment is appropriate.

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