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Filler Treatments

Posted: 6:20 a.m. Sunday, September 30, 2018

By Anita Mandal, M.D.
Question: I had Bellafill in my cheeks and temples and Restylane Refyne in my mouth corners. I got some mild bruising in my left temple but major bruising on my right mouth corner. Once the bruising went away, I liked the final results but I don’t want to go through dealing with two weeks of bruising when I have more fillers. What can I do to prevent this?

Answer: While you can get bruising from any injectable filler placed in any part of the face, there are several ways to reduce the amount of bruising you experience.

If you are prone to bruising, be sure you are off all aspirin, non-steroidal anti inflammatory medications, anticoagulants and any herbs and vitamins that predispose to bruising. First always, check with your primary care doctor if it’s safe to stop any medication or product prior to a cosmetic procedure.

Injector technique can have an impact on bruising. A skilled injector can reduce your chances of bruising by diminishing the number of needle insertion points, avoiding visible blood vessels and using “atraumatic” technique whenever possible. However, even in the presence of perfect technique, each patient is different and there is no way to guarantee you won’t bruise. Understanding this is part of being a realistic patient with realistic expectations.

The use of micro-cannulas for injection can also significantly reduce the chances of bruising. I commonly inject Bellafill with micro-cannulas which have significantly reduced discomfort, swelling and bruising, compared to the use of a needle. Not all injectors are skilled with the use of micro-cannulas. Also, be aware that not all fillers or facial areas can be injected with micro-cannulas. In some cases, a needle is required.

We routinely carry Arnica Forte for my surgical patients. In patients who are prone to bruising and having less invasive treatments such as fillers, a loading dose of Arnica Forte followed by four more twice daily doses can be quite effective. Arnica Forte is available for sale through my office. Many patient ask why they can’t just use the arnica sold at supplement stores. Places like Whole Foods carry arnica at 100 mg dosages. In order to have the benefits of arnica, it’s important to use the minimum effective dose which is 1,000 mg. Arnica Forte also contains Bromelin, as part of its formulation, to stabilize blood vessels from leaking.

Careful consultation with a Board Certified Facial Plastic Surgeon is the first step in assessing your injector filler and what measures you can take to reduce your chances of post-treatment bruising.

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Bellafill, 60 Minutes: The 5 Year Filler – Dr. Mandal is a BellaDiamond physician in the top 1% of expert Bellafill injectors in the world

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