What Not to Do after Fillers: Exercise, Saunas and Sleep

Why are some things avoided after filler?

Hyaluronic acid filler is a gel-like product injected under the skin with a needle or a cannula (a thin tube with a blunt tip). In the first hours and days after the treatment, the needle entry points have not yet fully closed, there is mild swelling in the tissue and the gel is settling into place. Almost all the behaviours that are recommended to be avoided during this period serve three purposes: not increasing bruising and swelling, preventing germs from entering through the entry points and preventing the gel from being affected in an unwanted way.

Let us say one important thing from the start: most of these recommendations have not been tested in comparative studies. Most are based on the consensus of expert panels made up of experienced physicians and on sensible reasoning. The time periods also vary from source to source. Below, we have set out the reasoning for each recommendation and how strong the evidence is. For the treatment itself and day-by-day care, see our article “Hyaluronic Acid Filler”; for the general principles that apply to all aesthetic treatments, see our article “Aftercare Following Medical Aesthetic Procedures”.

The periods in the table are general information. In areas such as the lips, under the eyes and the nose, or with high-volume treatments, your physician may recommend longer periods. What applies to you is your physician’s instruction.

When can you exercise after filler?

An international expert panel states that avoiding strenuous exercise for 24 hours after the treatment is generally advisable to reduce the risk of bruising and swelling. The American Academy of Dermatology (AAD) also recommends waiting until the next day for exercise and strenuous activities. The reasoning is this: strenuous exercise increases blood flow and blood pressure in the face; this can lead to more blood leaking at the needle points, that is, to more noticeable bruising and swelling.

There is no study that directly compares this period; the recommendation is based on expert opinion. The AAD states that most people can return to their daily activities after leaving the treatment. In other words, ordinary activities such as walking or housework are not the subject of this restriction. Weightlifting, running, intense cycling, head-down positions and contact sports in which the face could be hit are activities that call for more care. Swimming pools should be asked about separately, both because of germs in the water and because of goggles pressing on the face.

Turkish baths, saunas and heat after filler

A European expert panel that issued an opinion on late-onset filler reactions recommends avoiding saunas, sunbathing and sunbeds after the treatment, but does not give an exact period. A hot environment widens the blood vessels and can make swelling more noticeable. This is a well-known bodily response; however, there is no direct study showing that heat after filler worsens the results.

There are additional reasons where the Turkish bath (hamam) is concerned: besides staying in a hot and humid environment for a long time, there is scrubbing of the face with an exfoliating mitt (kese) and contact of the face with soap lather and water. The same panel also recommends not touching the entry points after the treatment and avoiding contact of these points with tap water. It is therefore advisable to postpone Turkish baths, saunas and very hot showers until the period your physician gives has passed. For when cold and warm applications help, see our article “Bruising and Swelling”.

Pressing on and massaging the area

The AAD recommends not touching the treated area for three days unless your physician specifically asks you to massage it. The European expert panel also states that touching can lead to germs entering and recommends avoiding facial massage. In some cases, the physician may correct a small irregularity that forms in the early phase by massaging it themselves; this is a decision the physician makes after seeing the area.

The drawbacks of massaging on your own are these: you may carry germs from your hands to the entry points, increase the swelling and cause gel that has not yet settled to spread. More importantly, if there is a warning sign such as sudden severe pain or a colour change, losing time with massage is dangerous. What to do in that case is explained in our article “After Fillers: When Is It an Emergency? Vascular Occlusion and Other Warning Signs”.

Other things also put pressure on the face: tight glasses frames, face masks, helmets, sleep masks, facial massage tools that press on the face and massage tables with a face cradle. Consult your physician about these too in the first days. If you have had nose filler, ask specifically about glasses.

Is it a problem to sleep face down after filler?

Many physicians recommend not sleeping face down or leaning on the treated side of the face on the first night or the first few nights. The reasoning is the idea that a pillow pressing on the area for a long time may increase swelling and affect gel that has not yet settled. There is no study that supports or refutes this recommendation; it is based entirely on expert experience.

In practice, sleeping on your back with your head slightly raised on a pillow is an easy precaution for most people. It is normal to turn over in your sleep; lying on your side for one night will most likely not cause a problem. Even so, if swelling you notice in the morning does not decrease over the days, or if you see a new irregularity, show it to your physician.

When can you wear make-up after filler?

Sources differ on make-up. The AAD states that after most fillers a person can apply make-up before leaving the treatment facility. The international expert panel, on the other hand, recommends avoiding make-up after the treatment. The European expert panel states that the recommended waiting time varies between 5 minutes and 24 hours, and that if make-up is to be applied, using clean, newly opened products is ideal where possible.

The reasoning is infection: the needle entry points can stay open for a few hours; used brushes, sponges and products can carry bacteria. So wait for the period your physician gives before applying make-up; if you apply make-up, do so with clean hands and a clean brush and sponge, without rubbing the area. Separate periods may be recommended for lipstick after lip filler and for eye-area products after under-eye filler.

Alcohol after filler

Many physicians recommend avoiding alcohol in the first 24–48 hours. The reasoning is that alcohol widens the blood vessels and can increase bruising and swelling in some people. This recommendation is widespread; however, we could not find a study directly showing that alcohol after filler changes the results or the complications. You can therefore think of avoiding alcohol not as a ban backed by strong evidence but as a simple precaution aimed at not increasing bruising.

Alcohol can also make it harder for you to notice warning signs such as pain or a colour change. For information on other factors that increase bruising and on blood-thinning medicines, see our article “Bruising and Swelling”. Do not stop a medicine you take regularly on your own unless your physician recommends it.

Can you fly after filler?

We could not find a published study showing that air travel after filler affects the results or the complications. Because hyaluronic acid gel contains no air, changes in cabin pressure are not expected to affect the gel directly. Staying still on a long journey can cause mild facial swelling in some people; this is usually temporary.

The real issue with flying is about safety: the warning signs of serious problems such as vascular occlusion mostly appear during the treatment, immediately afterwards or within a few hours; late-onset problems, on the other hand, can appear days or weeks later. During this period, it is important that you can reach your physician and the enzyme that dissolves the filler (hyaluronidase) quickly. So if you will be going on a long journey straight after the treatment, especially abroad, discuss the timing with your physician in advance. In the first days, also avoid using a sleep mask or a neck pillow that presses on the face during the journey.

Dental treatment and other invasive procedures after filler

The European expert panel recommends waiting at least 2 weeks after filler for dental treatment, invasive diagnostic procedures (for example endoscopy) and surgical procedures. The reasoning is that during these procedures bacteria may enter the bloodstream, be carried to the filler area and form a biofilm (bacteria settling inside a thin protective layer) around the filler. The panel considers this risk to apply to all dental procedures, including tooth whitening, and reports that in a small study six of seven people who developed late nodules had recently had dental treatment.

This association is based on small studies and expert opinion; causation has not been proven. In addition, this recommendation is for planned procedures that can be postponed. Do not postpone an urgent dental problem such as a painful tooth abscess; tell your dentist that you have recently had filler, and tell the physician who did the filler that you have had dental treatment. How late-onset swelling and nodules are assessed is explained in our article “Filler Complications”.

Laser, radiofrequency, ultrasound and other procedures

The European expert panel recommends avoiding facial laser, radiofrequency (an electric current that heats the skin) and focused ultrasound treatments after filler; it does not give an exact period. The information on this subject is based not on human studies but on animal and laboratory studies. In an experiment on pigs, when radiofrequency was applied to skin that had been treated with filler, the inflammation and tissue reaction around the filler increased. In a laboratory study on cross-linked hyaluronic acid placed in pig skin, one type of laser with a wavelength of 1064 nm broke down a substantial part of the gel, whereas focused ultrasound and two other types of laser had little effect.

These results do not tell us with certainty which procedure affects filler in humans, to what extent, or how long one should wait. They do suggest, however, that a procedure that produces heat may affect the filler and the tissue around it. So if you are planning facial laser, radiofrequency, focused ultrasound, a chemical peel, a facial or another injection, decide on the interval and the order of the two procedures together with the physicians who will perform both. If you will have a procedure at another centre, tell them that you have recently had filler and in which area.

A note on vaccinations and illnesses with fever: after flu, chickenpox and COVID-19 vaccinations, or after flu-like illnesses, delayed swelling and redness have been reported in areas previously treated with filler. This is uncommon and is not a reason not to be vaccinated. If you are planning a vaccination, tell the physician who does your filler; if timing is needed, it is assessed together.

Sun and sunbeds

The AAD recommends staying out of the sun and not using sunbeds after filler; the European expert panel also recommends avoiding sunbathing and sunbeds. The reasoning is that sun and heat can increase redness and swelling in the treated area. This recommendation is also based on expert opinion, and the period is not clear. In practice, not staying in direct sunlight for long in the first days and using a hat and shade is an easy precaution. For when and how to apply sunscreen, see our article “Sunscreen Guide”.

Which symptoms are normal, and which are not?

The aim of the restrictions is to support normal healing. If you have broken a rule without realising it, for example if you went to the gym the next morning, this usually does not cause a problem. What matters is watching for symptoms. The U.S. Food and Drug Administration (FDA) states that most side effects such as swelling and bruising appear shortly after the treatment and that most pass within a few days to a few weeks, while some side effects may appear weeks, months or years later. The AAD also reports that redness, swelling, tenderness and bruising usually go away within 7–14 days. If you have a symptom such as a vision or speech problem, loss of strength or shortness of breath, call 112 (or your local emergency number) without waiting.

If you have broken a rule or are unsure

1. First look at the symptoms: if there are problems with vision or speech, loss of strength or shortness of breath, call 112 immediately.
2. If there is whitening of the skin, a purplish net-like colour or sudden severe pain, call the physician who performed the treatment immediately; do not apply massage, heat or ice to the area.
3. If there are no symptoms, or only mild swelling and bruising, continue the restrictions from where you left off and keep an eye on the area.
4. If swelling, redness or pain does not decrease or increases the next day, contact your physician with a photo of the area.
5. Tell your physician clearly what you did (for example exercise, a Turkish bath, dental treatment) and when; this information makes the assessment easier.

What to ask before the treatment

Most restrictions vary depending on the physician, the area and the product used. So ask for written aftercare instructions before the treatment and plan your calendar accordingly. If you are planning an important event, a journey, dental treatment, a vaccination or another aesthetic treatment, mention it before the treatment; your physician can suggest a date for the filler accordingly. For the early signs of infection, see our article “Infection after Aesthetic Treatments”.

Limits of the evidence: the recommendations on exercise, heat, alcohol, sleeping position, make-up and air travel after filler are largely based on expert consensus and clinical experience; there are no randomised studies comparing these factors. The association between dental treatment or vaccination and late reactions is based on small studies and case reports, and the effect of energy-based devices on filler on animal and laboratory studies. This page is for general information; it does not replace an examination.