Bruising and Swelling: How Long Do They Last after an Aesthetic Treatment, How Can They Be Reduced and When Should You Worry?

Why do bruising and swelling occur after an aesthetic treatment?

As the needle passes through the skin, it can touch very small blood vessels. Blood leaking from the vessel collects under the skin and appears as a bruise. Swelling, on the other hand, is the tissue’s natural response to the procedure: fluid and immune cells flow into the area. With filler treatments, the product itself can also cause extra volume and fluid retention (oedema) for a while.

This is why bruising and swelling are usually not a complication but an expected result of the procedure. What matters is knowing the expected course and recognising symptoms that deviate from it.

How long does a bruise last? Is the change in colour normal?

A bruise usually goes away on its own within a few days to two weeks. This time varies depending on the size of the bruise, the area and the person. In areas where the skin is thin, such as under the eyes and the lips, bruising may be more noticeable and last longer.

The colour of a bruise changes over time: first red-purple, then bluish, later turning green and yellow-brown before fading. This change in colour shows that the body is clearing the leaked blood, and it is normal. A bruise with clear edges that stays around the injection point and fades over time is usually not a cause for concern.

How long does swelling last?

Swelling usually increases in the first days and then starts to go down. With treatments to the lips and around the eyes, swelling may be more marked; it may look worse in the mornings, especially after waking up. Swelling in the first days can be misleading about what the result will look like; so wait for the time your physician recommends before judging the final appearance.

For other expected effects after filler and botulinum toxin (commonly called “botox”), see our articles “Filler Complications” and “Side Effects after Botulinum Toxin”.

After which treatments are bruising and swelling more common?

Some bruising and swelling can occur after almost any procedure in which a needle enters the skin. However, how often it happens and how noticeable it is vary from one procedure to another:

• Filler treatments: swelling and bruising are common, especially in the lips and under the eyes. The product itself can also create extra volume for a while.
• Botulinum toxin: small bruises at the injection points and short-lived mild swelling are usually seen.
• Mesotherapy and similar multi-point injections: because there are many injection points, small scattered bruises and bumps may occur.
• Thread lift: because threads are placed under the skin, swelling, bruising and a feeling of tightness may be more marked and last longer.
• Lasers and energy-based devices: with some treatments, swelling and redness, and with some vascular lasers temporary purplish marks, may be an expected effect.

Before your treatment, ask your physician what to expect afterwards. That way you will not worry unnecessarily about normal swelling, and you will not miss a symptom that is not normal.

What increases the risk of bruising?

• Blood thinners and some medicines that affect blood clotting.
• Aspirin and some anti-inflammatory painkillers.
• Some supplements: products such as high-dose vitamin E, ginkgo and garlic supplements have been reported to increase bruising.
• Alcohol.
• A history of bleeding or clotting disorders.
• Areas where the skin is thin and rich in blood vessels (under the eyes, lips).

Do not stop a blood thinner or any other medicine your doctor has prescribed on your own to avoid bruising. These medicines are used to prevent serious problems such as a heart attack, stroke or blood clots; stopping them can be far more dangerous than a bruise. Tell your physician about your medicines and supplements before the procedure; if necessary, the decision is made together with the physician who prescribed your medicine.

How can bruising and swelling be reduced?

The following measures are general principles in addition to your physician’s instructions. The instructions your physician gives you always take priority.

• Cold compresses: if your physician has recommended it, wrap ice or a cold pack in a clean cloth and apply it for short periods. Do not put ice directly on the skin and do not press on the area.
• Head elevation: keeping your head slightly raised on a pillow during the first nights may help reduce swelling in some people.
• In the first days, avoid strenuous exercise, saunas, Turkish baths (hammams) and very hot environments for as long as your physician recommends.
• You may be advised to avoid alcohol in the first days.
• If you need make-up to cover a bruise, apply it gently and only after the time your physician recommends.

There are limited data suggesting that some herbal creams or supplements may reduce bruising; however, the evidence is limited and they are not routinely recommended. Do not start supplements or medicines without consulting your physician. For long-lasting bruises, your physician may consider certain light-based treatments; this also requires an examination.

What should you not do?

• Do not apply heat to the area; in the first days it can increase swelling.
• Unless your physician specifically recommends it, do not massage, rub or press on the area.
• Do not try to drain a bruise with a needle or any other method.
• If you need a painkiller, ask your physician which one you can take; some painkillers can increase bruising. Do not stop your prescription medicines on your own, however.
• Do not try methods suggested on social media.

For general aftercare principles, our article “Aftercare Following Medical Aesthetic Procedures” can be a useful guide.

Which bruising and swelling are not normal?

The following symptoms may not be ordinary bruising or swelling. Especially after filler treatments, colour changes accompanied by pain can be a sign of vascular occlusion. For detailed information, read our article “After Fillers: When Is It an Emergency?”.

Signs of infection usually appear a few days after the procedure: increasing redness, warmth, pain, discharge or fever. If you have these symptoms, see a physician without delay; for details, see our article “Infection after Aesthetic Treatments”. For signs of allergy, our article “Allergic Reactions in Aesthetic Treatments” is also a useful guide.

How can ordinary bruising be told apart from vascular occlusion?

This is one of the most common questions after filler. An ordinary bruise is usually a well-defined mark around the injection point; apart from mild tenderness, it does not cause significant pain, and it fades over days as it changes colour.

With vascular occlusion, on the other hand, the discolouration can spread beyond the injection point like a net or lace pattern; the area may be pale, whitish or cold, and the pain is clearly greater than expected. It is not always possible to make this distinction reliably at home. The moment you have any doubt, do not wait: call your physician; if you cannot reach them, go to the emergency department.

What can your physician do?

If bruising or swelling is not following the expected course, your physician will first examine you and assess the cause. Depending on the situation, they may recommend monitoring; if they suspect an infection or allergy, they can plan the appropriate treatment; if they suspect a filler-related problem, they can carry out the necessary intervention or refer you to the relevant specialty. If there is a large collection of blood under the skin, the physician also decides whether it needs to be drained.

Normal, consult your physician, or emergency?

Whenever you are unsure, call the physician who performed the treatment. In an emergency, tell the team you go to which procedure you had, when, and with which product if you know it.

What can be done before the procedure to reduce the risk of bruising and swelling?

To reduce the risk:

• Before the procedure, tell your physician about all the medicines, vitamins and herbal supplements you take.
• Plan with your physician whether to pause any over-the-counter painkillers and supplements; for prescription medicines, get the opinion of the physician who prescribed them.
• If you bruise or bleed easily, say so.
• Ask your physician about limiting alcohol in the days before and after the procedure.
• If you have an important event, plan the procedure well in advance.
• Have the treatment done by an experienced physician in a licensed healthcare facility.

An honest note on the limits of the evidence

How long bruising and swelling last varies depending on the type of procedure, the area, the product used and the person. Some of the methods said to reduce bruising have not been proven in well-designed studies. For this reason we do not give exact durations or effectiveness rates; the most reliable information for you is the assessment of the physician who performs the procedure.