Botox and fillers are well-known as short, simple facial rejuvenation treatments that require no downtime, but will you have bruising afterward? Dr. Elizabeth Hernandez says most patients do not bruise. However, any injectable treatment carries a risk of bruising, even if you are not taking a blood-thinner. Patients that take anticoagulants (over the counter or prescribed) tend to develop some bruising.
Dr. Hernandez takes steps during your treatment to help prevent bruising, and there are things you can do before and after treatment that will also help.
Before your Appointment
Dr. Hernandez recommends avoiding blood-thinning products for 10 days prior to the injectable treatment to minimize bruising risk. If you take anticoagulants (or blood-thinners), she suggests asking your primary care doctor whether you can stop the treatment temporarily. For example, some patients who take aspirin for heart health typically stop the aspirin for about 10 days ahead of time if their physician allows that.
If you are taking anticoagulants and don’t want to discontinue treatment, Dr. Hernandez says you can still get injectable treatments. She will make sure you understand the propensity for bruising and longer recovery time.
It’s also a good idea to avoid certain types of over-the-counter products for 10 days prior to the treatment to minimize the risk of bruising. This includes aspirin, ibuprofen and other NSAIDs (non-steroidal anti-inflammatory drugs) such as Aleve and Advil as well as supplements such as fish oil, omega-3, Vitamin E, green tea and herbal supplements (ginkgo biloba, for example).
Many people don’t realize that supplements and other everyday products we eat or drink can act as blood thinners or have other unintended consequences. If you aren’t certain about anything you’re ingesting, research it online or ask Dr. Hernandez ahead of time so you don’t inadvertently make your recovery more difficult.
During your Visit
Knowing that a patient is prone to bruising helps Dr. Hernandez modify her technique to help minimize risk. She will apply direct pressure to all injection sites immediately after and for a longer period of time. She will also apply arnica cream and cold therapy with a reusable ice pack that patients can then take home to continue to use.
Back at Home
Since you can bring home the reusable ice pack you use in-office immediately after a Botox or filler treatment, you can continue to use it intermittently for the first day. Taking arnica tablets as well as applying Arnica cream or gel directly to the treated areas helps to minimize bruising, swelling and pain.
Touching the treated area does not affect bruising. Nonetheless, Dr. Hernandez recommends that you not touch the area for the first few hours to minimize the risk of infection at the needle puncture sites. Washing your face is good, but don’t apply makeup or other skin care products until the following day, to allow the skin to heal after the injection treatment.
Keeping your head elevated (not laying down flat or leaning over for prolonged periods of time) for the first 4 hours after Botox or filler treatments is also helpful. Sleeping with your head elevated on an extra pillow for 1 or 2 nights can also help minimize swelling after filler injection treatments.
The association between cigarette smoking and delayed wound healing is well recognized. Smoking also increases the risk of bruising and bleeding after treatments. But smoking is counter-productive in more ways, since it speeds up the aging process in the skin and contributes to wrinkles. So if you smoke you’re negating the effects of Botox and fillers (or you’ll need more to achieve improvement). That just doesn’t make sense!