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Lip fillers can look so good when they’re done well, but the bruising immediately after can look, like, scary. 

If you just got lip injections and you’re worried about the swelling, or if you have been holding off on getting a lip filler treatment because you’re worried about bruises, read on!

In this post, you’ll find out why lip filler injections bruise, how to reduce bruising before and after treatment, which fillers bruise more or less, when to schedule your filler before an important event and how long recovery lasts after lip fillers. 

You’ll also learn about how to tell normal bruising apart from a dermal filler allergy or a vascular occlusion, the most serious possible side effect of dermal filler treatment.

If you’re looking for fuller lips, read on!

Why do lip filler injections bruise? What are the other side effects of lip fillers?

Lip filler bruising isn’t really a result of the filler itself – it’s because of the needles used. You might have two injections of a local anesthetic before you begin. During the process, you’ll have somewhere between two and fourteen injections that actually add the hyaluronic acid dermal fillers to your lips. 

So that’s as many as 16 possible injection site bruises!

Our lips have so many small blood vessels and nerve endings. This gives them their color and makes them so sensitive (which is good! It makes us enjoy kissing!). But it also means that swelling and bruising are the most common side effects of lip fillers. There are just so many vessels and so much blood flow in the area that it’s almost impossible to avoid bruising completely. 

Overall there are minimal side effects during or immediately after lip augmentation, but you may experience:

• Nausea or dizziness after the injection (often as a result of the anesthetic not the filler!)
• Lip swelling that looks asymmetrical or uneven
• White or pale spots around where the needle went in 

All of these are normal and temporary and might happen with any type of filler or any other injectable treatment. 

If you feel a sudden extreme pain, that’s not normal and might be a sign of vascular occlusion (more on that below). 

Do some filler types bruise less?

Yes, some type of dermal filler are advertised as swelling less than others. Revanesse Versa says that their trials show 50% less swelling than other comparable fillers. (This isn’t a sponsored post, and it’s worth noting that they pay for these clinical trials themselves!) That means about half the trial participants saw that swelling.

Restylane Kysse also advertises itself as having less swelling immediately after injection – they report that 90% of participants saw some swelling but 72% said it was tolerable and did not interfere with daily activity. (Data is from their website –scroll down to page 4 for the table.) Honestly, I trust this number more–if you’re getting an injection, there’s going to be swelling. 

The largest factor in whether or not you get bruising isn’t the filler type, though – it’s the injector and injection process!

An experienced injector will give you less bruising in any type of dermal filler injections: lip fillers, but also tear troughs, cheek fillers, whatever.  A plastic surgeon or board-certified dermatologist are your best choice. They have more expertise and may choose to do a more advanced injection method, like doing all or part of your filler procedure with a cannula.

(Cannulas are not necessarily the best choice every single time, but they can move around/between blood vessels and result in less bleeding and bruising overall. An exeprienced injector can best make this choice.) 

If a healthcare provider like a plastic surgeon is out of your budget, make sure that you’re going to a highly experienced aesthetic practitioner. You may be able to see an Aesthetic Nurse Practitioner or RN in a derm or plastic surgery office. This varies from state to state in the US. 

You might even get better treatment from an NP or RN. They generally spend more time with you, and they might do injections all day every day. And if you’re in a doctor’s office, you can feel confident that there’s a high standard for treatment. 

Even if a doctor’s office is not possible for you, be picky about where you go. This is not the kind of thing you want to take risks or cut corners with. (And if you don’t believe me, scroll down. Look at the section titled “Is this regular lip filler swelling or a vascular occlusion?”)

How do I know how much I will bruise?

Some of the outcomes of lip fillers depend on your body. 

Are you, personally, someone who bruises a lot? If you knock your hip on a table, are you likely to have a bruise for a week? 

If that sounds like you, scroll down to look at options for reducing your swelling and bruising before and after your injections. 

Also, if you’re taking blood thinners for medical reasons, you’re more likely to experience bruising. This requires a little phone tag – call your injector two weeks before your appointment, or before you make your appointment. They may advise discontinuing the blood thinners for a week or ten days. 

Depending on why you take the medication, this might not be a good idea! So call your prescribing physician and ask them if it’s okay for you to skip a week of your blood thinners. Take your doctor’s word more seriously than your injectors! 

You can also reduce bruising by skipping ibuprofen, aspirin, alcohol, and caffeine for three days before your injections. 

What is the healing process day by day after lip filler treatment?

Day of treatment

Fillers have more than immediate results. By that, I mean that your lips will look larger immediately after treatment than your actual final results. 

Fillers will almost always look uneven immediately after injection, too. That’s not because your injector messed up– it’s swelling in the injected area.  

The amount of swelling will depend on the filler used, whether it was a blunt-tip needle or a sharp needle or a cannula, and a few other factors. The way the injections were done may mean that there’s swelling in the surrounding tissue around your lips as well. 

Days 1-3/first 72 hours

The worst of the swelling and bruising will happen in the first couple of days. Whether it’s 24 hours or 72 hours will really depend on you and how your body reacts to small injuries. 

The “big” swelling up front is more of your body’s reaction to the injections and the microtrauma of the needle or cannula. Similarly, the bruises are caused less by the filler itself and more by the needles entering your skin and puncturing the vessels in the lip. 

So if your body tends to swell, you may find that this last longer. You can best treat this with an ice pack or a heating pad to try to calm the swelling and bruising. This is true of fillers in all areas of the face. 

Bruises can be treated with arnica – more on that in a minute. 

First two weeks after lip filler

After the big, immediate swelling has gone down, you’ll have a better sense of what your lips look like, but the swelling may not be completely gone yet as your body adjusts to the filler. 

You’re probably seeing 90-95% of your final results, and your final lip shape is probably set by now, though your lips may come down in size a bit more. You’ll likely still have some bruising.

Many offices won’t schedule a follow-up appointment until 3-4 weeks out for this reason! People are often freaked out in the first two weeks that their lips are bigger than they wanted. Especially if it’s their first time getting filler. 

Wouldn’t it be terrible to go dissolve your filler because you were unhappy with it before you saw your full results? 

You may still be experiencing bruising through the end of the first week, though this is very individual.

If you’re looking for a day-by-day photo log of someone’s lip filler healing journey, I thought this Redditor’s photos were a great illustration.

Her lips look so uneven in the day 1 photo but look great by day 9! And her bruising appears to peak on day 5 and mostly resolve by day 8. 

Why are my fillers swelling months later?

If you’re getting sudden inflammation or swelling now, weeks to months after your injections, it’s called late-onset inflammatory response. According to the linked article, it is less common in lip fillers but still possible. If you’re experiencing a late-onset inflammatory response, where your fillers are suddenly swollen and red, call your practitioner back and they can give you oral steroids to treat it. 

I’m getting fillers soon. What can I do to reduce my swelling before my lip filler procedure?

It is so smart to try to reduce your risk of swelling in the days before your lip treatment! Try some or all of the following to get the most minimal bruising possible:

• 7-10 days out: If you take blood-thinning medications, talk to your doctor about discontinuing them. Your health is more important than your lip fillers! If your doctor says no to taking a week off from your meds, listen to her! If you take fish oil supplements, discontinue those, too.
• 3 days out: Stop taking or ibuprofen, aspirin, and discontinue alcohol and caffeine. 
• Day before: if you’re planning to take or use arnica, start now. (More on this in the next section!)
• Day of: Skip strenuous exercise or physical activity, sauna, or anything else that will get your heart rate or blood pressure up.

This is an old wives tale, but I can vouch for it myself: the day before your treatment, try to eat fresh pineapple or drink pineapple juice. I’ve never done it myself for fillers, but I drank two glasses of pineapple juice the day before I got my wisdom teeth out. I got the best results from it! Minimal swelling and no chipmunk cheeks. And since you shouldn’t take ibuprofen, you want all the anti-inflammatory help you can get. 

Help! I got filler and my lips are swollen and bruised. What can I do now?

Lip filler aftercare includes managing your swelling and bruising. 

Immediately after you’ll probably be given a cold compress or ice pack to head off the swelling. (There are a few filler brands that recommend against this though! Ask your injector.) 

You can continue to use cold therapy over the next few days, but keep your sessions short (10 minutes or so). Keep the pressure of the ice pack light on your skin. Don’t press it down onto your lips or rub it around. 

Same day and the next days, Arnica montana, or vitamin K, can be used to reduce bruising. If you started it before the fillers, you probably saw less bruising than you would have otherwise. 

If you didn’t start arnica before your injections, it can still help afterwards. Arnica cream or arnica tablets are available. I prefer the cream personally– I like the VitaMedica Arnica + Vitamin K, but this Cocra Vitamin K cream is cheaper and also has good reviews.   

Over the next 2-3 days continue avoiding blood thinners, ibuprofen, aspirin, and fish oil for a day or two after your injections, as your bruising may not be “done” until then. You also want to avoid Vitamin E, and check your lip balm to ensure it doesn’t have Vitamin E in it. 

Is this regular lip filler bruising or an allergic reaction?

If you’re worried that you’re having an allergic reaction to your hyaluronic acid fillers, here’s how to tell. 

First: it’s pretty rare to be allergic to hyaluronic acid fillers compared to other injectables like Botox. Hylauronic acid is a natural compound in our bodies.

However, many modern fillers have lidocaine in them to manage the pain of injection, and you might be allergic to lidocaine. 

Because swelling is a natural reaction to fillers anyway, swelling shouldn’t be taken as sign of an allergic reaction.

However, if you begin experiencing hives or swelling inside your mouth or on your tongue, that probably means allergy. If your fillers feel itchy, that’s also a good reason to suspect allergy. 

If you feel any trouble breathing at all, that could be an allergy and you should see a doctor immediately. 

Your doctor may prescribe medication and may direct you to dissolve your fillers. Your health should always come first!! 

If you have existing allergies and want to test if you will be allergic to fillers, ensure that you’re going to a doctor’s office, not a medspa, for your fillers. When you are calling around to make an appointment, ask each office if they are willing to do an allergy test spot for you. If they say no, call the next office.

Is this regular lip filler bruising or a vascular occlusion?

Vascular occlusions are the most serious possible risks of any type of filler. In a vascular occlusion, filler is injected into a blood vessel, fully or partially blocking the blood flow, or so close to a blood vessel that it compresses blood flow. 

They are rare, and the better your practitioner is, the less likely it is to happen to you. This is the best possible reason to go see an experienced cosmetic surgeon. 

The first sign of a vascular occlusion is severe pain that is intense and feels like it’s in one spot. Overall lip pain or tenderness is not a sign of vascular occlusion. 

If you see blanching or a white spot that lasts, that’s also a sign that you might be experiencing a vascular occlusion. A temporary white or pale spot around an injection area is not a cause for concern, but if it lasts, it could be a sign of occlusion. The area may also feel cool or cold.

If you have that intense pain or blanching, go back to the injector immediately–don’t wait for additional symptoms, and don’t try to treat it yourself. 

If you don’t treat occlusions early, symptoms will continue: bruising will get bad in that area as the blood accumulates behind the occlusion, the area around the occlusion will swell. 

The final outcome of occlusion in lip fillers is necrosis or tissue death, which can be permanently scarring.

However– for the worst-case scenario girlies (like me): Lip fillers aren’t one of the primary places you’re likely to get an occlusion. If you’re not feeling intense pain in one specific area, it’s probably not an occlusion. But if you have any of these symptoms, don’t wait to get it checked. Better safe than sorry. 

Who shouldn’t get lip fillers?

If you have cold sores, you should be cautious in getting lip injections. If you make an appointment and have an active sore when the appointment comes around, it’s a good idea to cancel. You should also be aware that even if you have no active sores on your appointment day, the injection process can trigger them. 

If you take blood thinners and your doctor says you can’t discontinue them long enough to get lip fillers, listen to your doctor over your injector! There’s no sense in getting fuller lips then throwing a blood clot.

Now that you know how to manage bruising, get lip fillers without fear! And if all else fails — red lipstick cures everything.