How can you avoid bruising with filler injections?

Injections can always cause bruising.  (Sorry. Not to be graphic, but there is no way to put a needle in the skin without getting some blood.)  You don’t have to do these things.  But if you want to stack the deck in your favor against bruising, what can you do to help?

PRE INJECTION: (starting two weeks out)

• Avoid things which make you bleed.  Aspirin, NSAIDs (like advil, motrin, naprosyn), vitamin E (the amount in a multivitamin is ok. A vit E pill is not), and herbals (anything heart healthy = makes you bleed.  Ex: ginseng, gingko, fish oil, ginger.  See link.)  The effects of these medications stay in your system for two weeks.  So stop two weeks ahead of time.
• Herbals which reduce swelling and bruise.  Arnica and Bromelain are the two biggies.  You should start these two days prior to the procedure and take for a week afterwards.
• Don’t be hot and sweaty when you come in.  If you just worked out and come in, your skin blood vessels are dilated to get rid of all that extra heat.  Dilated blood vessels = higher chance of bruising.
• What area are you doing?  The nasolabial fold (parethesis around your mouth) don’t tend to bruise much.  The lips and area under the eye are more prone.

DURING

• Ice, elevation, small needles to inject, and a dose of dumb luck.  I shine a bright light on you to try to illuminate where the vessels are. 

AFTER

• Ice
• Elevate (this includes sleeping with an extra pillow that night)
• Herbal medications arnica and bromelain
• Avoid being hot (I see higher rates of bruise with injections in the summer.  When your body is hot, your skin blood vessels dilate to get rid of heat. )
• No vigorous exercise for 24 hours.  (If you are really bruised, then longer. Wait until your bruise is turning yellow green before restarting.)
• Avoid heavy lifting, straining, bending over. These all raise the blood pressure in your face, which leads to bruise.

Some people also just tend to bruise more easily.  Thin skinned and fair skinned women see bruise more easily.  If you have never done an injection before, do it at the end of a day on Thursday or Friday, so if you bruise you can recoup over the weekend.  For those who have done injections before, you tend to react the same way most of the time.