Mabrie Facial Institute
166 Geary Street
Floor 1300
San Francisco, CA 94108
Phone: (415) 445-9513
Text/SMS: (866) 618-9459
Monday–Friday 8 a.m.–5:30 p.m.
It’s often said that there’s no downtime with BOTOX and fillers, but that doesn’t mean there are no side effects or recovery process. It’s normal to have:
- Swelling
- Bruising
- Lumps/bumps/unevenness
- Mild redness
The degree to which you experience these can vary greatly. We’ll provide you with all the info you need to minimize the expected side effects and recover as quickly, comfortably, and beautifully as possible.
It’s also important that you understand the abnormal side effects—things that are UNCOMMON and require medical attention. These include:
- Mottled/spotty discoloration
- Throbbing or increasing pain
- Blisters
- Delayed swelling after 2 or more months
If you experience any of these, you should call our office immediately. We have the tools and experience to address these rare complications right away. But you don’t have to have an emergency to call us; we’re always here for you if you have any questions about your treatment or recovery. We’ve also put together this page to help you understand what is and isn’t normal after treatment.
What To Expect After Dermal Fillers and BOTOX
Common, Mild Side Effects During Healing
The most common side effects of BOTOX injections are localized redness, minor swelling, and sometimes itching or irritation. These are usually very minor and resolve within a day or two. Dermal fillers can produce more significant and longer-lasting side effects; read on to learn what’s normal.
SWELLING After BOTOX and Dermal Fillers
Swelling is the enlargement of a body part resulting from fluid accumulation. This happens whenever there is trauma to a part of the body; something as simple as a needle poke can cause swelling. The body detects that there has been an injury, and sends cells to start to heal the area. The fluid in these cells produces swelling. Swelling is the most common of the possible side effects of dermal fillers. It typically peaks 24 to 48 hours after treatment, and can last 4 to 6 weeks.
The amount of post-filler swelling differs for each individual treatment and depends on a few factors:
- Area treated – lips, forehead, and jawline tend to swell the most
- Number of injection entry points, passes of the cannula, and syringes used during treatment
- Individual physiology and medical history
Normal Swelling by Area
-
Before Lip Filler 
Immediately After Lip Filler 
4 Weeks After Lip Filler -
Cheek Swelling Immediately After RADIESSE 
Cheek Swelling 1 Day After RADIESSE 
Cheek Swelling Resolved at 6 Weeks Radiesse: Has more initial swelling than other fillers.
-
1 Day After Under Eye Treatment 
3 Days After Under Eye Treatment 
3 Weeks After Under Eye Treatment -
Swelling Immediately After Jawline Filler 
90% Of Swelling Resolved At 4 Weeks 
Swelling Completely Resolved At 8 Weeks Swelling after Jawline Filler: The jawline is one of the areas that swells the most.
-
Before 
Immediately After Botox Injections
Normal Swelling by Area
Lips
Cheeks
Radiesse: Has more initial swelling than other fillers.
Under Eyes
Jawline
Swelling after Jawline Filler: The jawline is one of the areas that swells the most.
BOTOX®
Ways To Minimize Swelling After Fillers
There are a few things you can do to minimize the swelling you experience after your dermal filler treatment, including:
- Apply ice to the area
- Keep your head elevated
- Take over-the-counter anti-inflammatories
- Avoid high-sodium foods or drinks
Your Injector will go over these tips and more at your appointment.
BRUISING After BOTOX and Dermal Fillers
Post-filler or BOTOX bruising is caused by a collection of blood under the skin. When there is injury to even a tiny vessel, blood can get trapped under the skin resulting in a bruise. The severity of bruising is not dependent on filler type, but rather on the size and type of injection tool used, as well as each patient’s anatomy and physiology. While bruising is a possible risk any time the skin is punctured, some treatment areas are more prone to bruising than others.
Our associates at Mabrie Facial Institute use a microcannula technique, which greatly reduces bruising.
Ways To Minimize Bruising After BOTOX and Dermal Fillers
There are a few things you can do to minimize bruising after your dermal filler treatment, including:
- Homeopathic Arnica montana, either in tablet or topical form
- Vitamin K oxide supplements
- Pulsed dye laser treatments
- Makeup
Below is information on some popular concealer brands, as well as tips for application.
MAKEUP CONCEALER TIPS
Product:
Ultra HD Underpainting Color Correcting Palette
Brand:
Make Up For Ever
Retailer:
Sephora, Amazon
Product:
Concealer Twins
Brand:
Physician’s Formula
Retailer:
Target, CVS, Walgreens, Ulta Beauty
Product:
Correct & Perfect All-In-One Color Correcting Palette
Brand:
Stila
Retailer:
Sephora, Ulta Beauty
APPLICATION TIPS
Neutralize: Neutralizing colors appear opposite each other on the Color Wheel. Use the Color Wheel to determine which concealer color will neutralize the color of your bruise. For example – to cover blue bruises, you would start by neutralizing the color of your bruise with orange makeup concealer. For red blemishes, you would neutralize the blemish color with green makeup concealer.
Apply: Use light fingertips to apply the concealer in blending motions, being sure to camouflage the entire bruise. Allow the concealer to set.
Finish: If desired, you may then apply a layer of foundation that best matches your skin complexion (be careful not to rub in the concealer while applying).
LUMPS, BUMPS, & UNEVENNESS After Fillers or BOTOX
Asymmetry and bumps may be seen or felt on any area of the face, especially under the eyes and along the jawline. This is most often due to normal swelling. If, after initial swelling has resolved (at around 6 weeks), you still have lumps or bumps, it could be from incomplete treatment or beaded filler. Please be patient, as this will be corrected at your second visit.
Examples of Lumps & Bumps After Filler
-
Before Treatment 
After 1st Jawline Treatment 
After Final Jawline Treatment -
Before Treatment 
Bumps/Shadows After 1st Treatment 
Resolved After 2nd Treatment -
Small Bump After Lip Filler 
After Dissolving Bump
Examples of Lumps & Bumps After Filler
Jawline Lump
Under Eye Unevenness
Lip Bump
Mild REDNESS After Fillers
After injury from treatment, the body heals itself with increased blood flow. This may cause an increased red appearance of the skin in the treatment area.
You can help resolve the redness with warm compresses, Arnica montana, and rest. It should resolve within a few days, so be patient.
IMPORTANT NOTE: If there is pain, warmth, or tenderness associated with redness, this could signify an infection. Fortunately, infection after fillers is very rare, but is a known risk after filler treatment.
Do’s & Don’ts After BOTOX/Neuromodulator Treatment (First 24 Hours)
It’s OK
- Light exercise
- Use Arnica gel or tablets
- Take anti-inflammatory or Tylenol if you develop a headache
- Apply makeup after 30 minutes
AVOID
- Massaging injected areas
- Laying face down for extended periods of time
- Using the sauna
REMEMBER: Your results won’t begin appearing for a few days, the treatment will be fully active at 10 to 14 days, so be patient!
Do’s & Don’ts After Filler Treatment
It’s OK
- Apply ice to minimize swelling – except to the nose
- Use Arnica gel or tablets
- Light exercise
- Take anti-inflammatory to minimize swelling
- Sleep elevated to help with swelling
- Wear mask, glasses or hat this won’t shift your fillers
AVOID
- Applying makeup for 4 hours
- Massaging injected areas
- Same day strenuous exercise
- Using saunas for 3 days
- Long flights same day as nose filler treatment
- Getting facials or other treatments until swelling subsides
REMEMBER: You will be at maximum swelling the day after your injections. Don’t let this swelling frighten you; be patient as it takes time to fully heal.
Unusual Side Effects of Filler Treatment
Call Our Office Immediately If You Experience Any of the Side Effects Depicted Below
(415) 445-9513
Mottled/Spotty Discoloration
Paleness or dusky gray-purple discoloration of an injection site could be a warning sign that the skin isn’t getting the blood flow that it needs. If the discolored area has a mottled, or lace-like pattern that spreads, and is accompanied by throbbing pain or numbness, this could mean you’re experiencing a rare complication called vascular occlusion. These signs would appear within the first hours to days after injection. This is when the filler is blocking a vessel and cutting off the blood supply to the skin. If this happens, your fillers will need to be dissolved immediately with Hylenex to restore proper blood flow to the skin. Call the office immediately as this may be a medical emergency.
Vascular occlusions usually occur in the office immediately after treatment. However, rarely, they may occur a few hours after treatment. Keep an eye out for the following symptoms:
Throbbing or Increasing Pain
Localized pain that increases over time, or becomes severe or throbbing during the healing process, is not normal and could be a sign that something more is going on. If you experience this, call our office immediately.
Blisters
Multiple blisters or small pustules near an injection site accompanied by pain, numbness, or skin discoloration, could be a sign of a vascular occlusion. This occurs when the blood flow to the skin is blocked by filler and the skin isn’t getting the blood and oxygen that it needs. If the blood flow is not restored promptly, blisters will appear, a sign that the skin is suffocating and damaged. These blisters could appear within 1 to 4 days post injection. Call the office immediately as this may be a medical emergency.
Delayed Swelling After Two Months
Swelling, tenderness, redness, or nodules that appear weeks to months after a treated area has already healed could be a sign of delayed swelling. This potentially occurs when one’s immune system becomes hyperactive (such as from a cold or a vaccine or unknown reason) and begins to attack the filler. While this is uncommon, it typically resolves on its own, but in some instances may require prescription medication. Delayed swelling is not a medical emergency, but it is still best to call our office to speak with a medical provider if you experience these signs.
BOTOX and Dermal Filler Aftercare FAQs
Should you massage lumps after fillers?
No, you should resist the urge to massage any lumps or bumps you feel after filler injections for at least 7 days. Be patient, these are not uncommon and they will resolve on their own.
Can I wash my face after BOTOX or fillers?
You can gently wash your face after fillers as long as you are very careful not to massage the treatment areas.
How long after lip fillers can I wear makeup?
Wait a few hours after treatment to apply makeup, concealer, moisturizer, and SPF. This will minimize the risk of infection. We suggest passing the time in our Lux Lounge before reapplication.
How long do cheek fillers take to settle?
Cheek fillers don’t really “settle,” but they take a few days to integrate with your tissue, and results do go through changes as swelling subsides. Usually, swelling will resolve within a week or two, with all noticeable swelling gone by 4 weeks. However, RADIESSE can cause more significant swelling, but it is temporary and usually resolves by 6 weeks.
What painkillers can I take after lip fillers?
Over-the-counter analgesics should be enough to ease any discomfort you feel after lip fillers. You’ll want to stick to acetaminophen products such as Tylenol, since ibuprofen products and aspirin are blood thinners.
When can I sleep on my face after fillers?
It is best to wait at least a few days before putting pressure on your treatment areas. This gives the fillers time to integrate with your facial tissue and completely take shape.
Can you exercise after fillers or BOTOX?
You can engage in light exercise on the day of your treatment, and more strenuous exercise starting 24 hours after your injections.
The MFI Advantage
MFI focuses exclusively on injectables, and has set the bar in the art and science of fillers for more than 15 years. Dr. Mabrie, trained as a facial plastic surgeon, has dedicated thousands of hours to carefully selecting and training our talented Injectors in the most innovative, effective, and safe techniques for injectables. There is no other practice in the Bay Area with the level of experience, education, and passion for injectables you'll find at MFI.
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