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How to prevent bruising after Juvederm and Restylane injections

how to prevent and treat bruising with dermal fillers juvederm and restylane

I love dermal fillers for treating wrinkles and volume loss. Nothing drags your face down and makes you look older more than volume loss in the upper cheeks with aging. It changes the “triangle of youth” where the widest part of the face is the cheekbones into the “pyramid of age” where the central face is flat and the jowls are prominent.. As my patients often lament “my face is melting”. Dermal fillers restore the lost volume to the mid face, lifting the jowls—called “liquid lift”.

I use Juvederm XC, Restylane or Sculptra for my patients to restore the youthful volume. Patients love it, it looks and feels natural. But sometimes the injections cause bruising which may prevent a patient from getting treatment when they want it. This is what I tell them to do and it really seems to help. Of course that means you need to read this now and plan ahead. There are also a few other post dermal filler tips.


  • For one week before, avoid aspirin, NSAIDs (Ibuprofen, Aleve, Motrin, etc.), St. John’s Wort, Vitamin E, Multivitamins, Krill Oil, Fish Oils, Flaxseed Oils, Omega-3, Gingko, Ginseng, Garlic and Glucosamine.
  • If you have frequent cold sores, contact us 3 days before treatment for medication.
  • Go to store and buy a fresh pineapple. It can be cut up by the store but must be fresh not frozen or canned. Eat half of the pineapple the day before your treatment. Pineapple contains bromelain which is felt to help decrease bruising.
  • Eat one quarter of the pineapple before you come in for treatment.
  • Eat the final quarter of your pineapple after your treatment.
  • You will receive Arnica gel to reduce bruising. Apply 5 times a day for 2 days after treatment starting 30 min after treatment.
  • We use GentleWaves LED treatment immediately after injection to reduce swelling and bruising.
  • We use cold packs before and after treatment.


  • For two days after, avoid aspirin, NSAID’s (Ibuprofen, Aleve, Motrin, etc.), St. John’s Wort, Vitamin E (including multivitamins with Vitamin E), Krill Oil, Fish Oils, Flaxseed Oils, Omega-3, Gingko, Ginseng, Garlic and Glucosamine.
  • You may feel lumpy areas inside your mouth or on lips for a week. This is normal.
  • Apply cold compresses for the first 8 hours to reduce swelling.
  • Avoid touching the treated area within 6 hours after treatment, except to apply Arnica. After that gently wash with soap and water. Foundation may be patted on.
  • If the lips were treated do not put pressure on them with a straw, water bottle nozzle, etc., for one week.
  • Do not put significant pressure on treated areas for one week (i.e. don’t lay face down on massage table cradle—I should be the one doing that.
  • Bruising may be covered with makeup. The most complete coverage is Dermablend Cover Cream (we get it at Ulta) although truthfully nothing covers it completely. Plan accordingly.
  • Very occasionally an area will be too “puffy” and need an injection of medication to reduce the amount of filler. You don’t have to suffer with an unfortunate result (that you got elsewhere, of course)

Remember if you are not my patient don’t pay attention to what I tell you. Pay attention to what your doctor tells you.


Posted on March 03, 2015 by amy caron

If bromelain is the effective ingredient in pineapple, what about taking a bromelain supplement?  What about Quercetin?  Also have you tried a homeopathic arnica remedy? It’s taken orally & placed under the tongue to dissolve.

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Posted on March 03, 2015 by Dr. Elaine Cook M.D.

Hi Amy, it seems that the Bromelain in fresh pineapple is more effective than the pills, but I do have patients who hate pineapple and take the Bromelain pills. They feel it does help. A fair amount of physicians recommend Arnica. It is helpful in bruising and we give our patients a free container of the topical gel form of it to use. I don’t usually recommend the oral form of Arnica, though many physicians do, because in high doses it has cardiac side effects. Most of the over-the-counter forms are in relatively low doses but since there is little control over supplement manufacturing I am concerned that a patient could accidentally get a higher dose than intended and have problems. Probably overly cautious, but I feel more comfortable that way. And I am concerned that a child or pet could get into it and overdose.

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