The face is a very vascular area – some areas more so than others. As you can see from this diagram, the veins and arteries run almost everywhere. Some are close to the surface and can be easily seen, while others run deeper and are invisible. When injecting, Dr. Stanislaw does his best to avoid blood vessels that are close to the surface of the skin.
If a blood vessel is injured while injecting, it can result in a bruise. It is not uncommon for a patient to have received many injections over a period of time and to have never bruised. If a patient has not bruised in the past, it does not mean that they will never bruise. This is because no two injections are administered in exactly the same way.
Botox and Dysport injections
A very small needle is used to inject Botox or Dysport, so the likelihood of injuring blood vessels is minimal. If a more superficial blood vessel is injured, it usually results in a small bruise that is typically the size of a pencil eraser. The most common areas for bruising during a Botox or Dysport injection are the crow’s feet, and seldom the forehead and glabella.
Restylane and Juvederm Injections
When injecting fillers such as Restylane or Juvederm, Dr. Stanislaw numbs the injection site with a local anesthetic. Although great care is taken to avoid blood vessels, it is possible to cause a bruise during this stage of the injection. For the actual injection, Dr. Stanislaw usually uses a blunt tipped cannula to inject the filler. A blunt tipped cannula significantly decreases the risk of bruising, but it does not eliminate it. The marionette lines (smile lines) have a higher propensity for bruising when compared to other areas of the face.
Planning your injections
It is impossible to predict who will bruise and for how long a bruise will last. As a general rule, the bigger the bruise the longer it will take for the bruise to resolve. However, there are always exceptions. There are times, when even a little bruise can take longer than expected to resolve. When planning injections, please keep in mind that you may bruise; schedule your injections well in advance of an event to allow ample time for recovery.
To lower the risk of bruising, patients are advised to stop any blood thinners one week prior to the injections. Aspirin, Advil, Motrin, Naprosyn, Vitamin E, fish oil, and herbal medications can thin the blood. Some patients ask if they can take Arnica prior to their injection. There are no controlled studies that prove that Arnica impacts the rate or severity of bruising, but patients can take Arnica if they so desire.