Bruising after dermal fillers is one of the side effects, and it is nothing to be concerned about.
Bruising occurs in about 19–24% of patients.
Getting a bruise is more likely when large volumes of filler are injected, or when the filler is injected into the lips or tear troughs.
Bruising is a temporary side effect, and it will fade quicker if you take the right measures. If you bruise easily, I recommend getting your dermal filler treatment 2-6 weeks before a big event.
First what is bruising after dermal fillers?
Bruising of any type is blood which has escaped the vascular system and spilled into the tissues.
It can be caused in various ways during different procedures. Some people worry there will be bruising after dermal fillers.
The most common would be needles puncturing vessels, which may be veins, venules, arteries
or arterioles, or capillaries, or by tearing vessels often with a cannula. Petechiae are the smallest
pinpoint bruises 1-2 mm across you may see at needle entry points.
Ecchymosis is simply skin discolouration, the medical term for a common bruise.
Purpura may refer to smaller bruises up to 1cm, while a haematoma, the most severe form of bruising, refers to bleeding under the skin that forms a palpable lump of clotted blood.
Each one of these scenarios will cause a different outcome, and we should be aiming to limit trauma
to all these vessels as much as possible.
Bruises are variable, and you may find yourself occasionally getting severe bruises from minor procedures or doing huge procedures and getting no bruising.
Factors which cause bruising after dermal fillers.
Understanding bruising after dermal filler causes in detail will also increase the number of ways you can reduce the risk.
I break down bruising into three main factors.
- THE DEGREE OF TRAUMA
- VOLUME OF BLOOD FLOW
- BLOOD CLOTTING
The first factor, trauma is the factor most easily controlled by the clinician.
This is the number of injections or the size of holes or tears in the tissue.
By focusing on technique, it is possible to dramatically decrease bruising, but it takes a relentless intolerance to bruising, I use precise needle control, and my anatomical knowledge to reduce trauma to a minimum.
The volume of blood flowing through vessels in the area being treated.
The second factor, the volume of blood flowing through the skin is affected by the cardiac output and states which increase blood diversion to the skin.
Most commonly the cause is raised body temperature, as thermoregulation mechanisms automatically divert blood to the skin’s surface.
The ability to cool the body down comes from our ability to divert blood into more superficial tissues and then to perspire to lose heat as sweat evaporates. Veins and arteries become dilated, and the quantity of bleeding and bruising increases proportionally.
In addition to temperature variations, hormones can also affect the blood in the skin. Blood flow prior to ovulation and diversion to the skin’s surface increase.
Peri-menopausal flushing may also Affect the amount of blood in the area being injected. Recent alcohol
ingestion can also dilate vessels, as both alcohol and the breakdown products of alcoholespecially acetaldehyde cause vasodilation which is a risk for bruising.
In these scenarios the increased volume of blood in the skin makes bleeding more likely and increases the amount of blood which may escape from the vessel. It’s also worth noting that very heavy exercise post procedure is a risk for severe bruising.
I personally have witnessed cases of patients ignoring advice and returning from a long run with two black eyes after a
tear trough (Under Eye) procedure.
Thirdly, the rate of clotting is a significant risk factor for bruising.
There are those patients who seem to stop bleeding rapidly, while others may slowly bleed under the skin for hours after the
procedure.
Clotting, like so many natural phenomena, fits to a degree on a bell curve. Though most people clot within the average time there are those who will take longer for no specific reason, and bruise more easily. There are of course many external factors that may affect clotting time too.
The most common will be the use of blood thinners. These include anticoagulants like warfarin, Low molecular weight heparins, and factor Xa inhibitors like rivaroxaban as well as anti-platelets like dipyridamole and aspirin.
None of these drugs are a complete contraindication to having injectable procedures, but this should be carefully discussed during the consent process. Weigh up the impact of a bigger bruise,
especially if it lasts for a month and the benefit of a treatment which may only last three months and make sure they accept that ratio.
Alcohol intake can both decrease and increase clotting times depending on the level of intake and individual variation.
How I reduce the risk of Bruising after dermal filler at Flawless Aesthetic Clinic.
I chat through the risks and how to minimise them yourself prior to treatment.
A patient who rushed to get to my clinic may be flushed and have a higher rate of blood flow. So I always take my time to chat and calm my clients before starting a procedure.
I use a cannula for dermal fillers where possible, needing less needle punctures.
I tend to withdraw needles slowly, especially when deep which may give layers of tissue time to close up and decrease blood pooling.
If bleeding occurs I Immediately compress and hold the area for a minute if bleeding seems notable.
I also offer post treatment care such as arnica gel and cold packs which you are given to take home.
