Swelling is normal, and it peaks later than you think
Filler swells. It is an injection into soft tissue, and the tissue responds.
What surprises people is the timing. You will usually look reasonable leaving the clinic and considerably worse the following morning, because swelling peaks at around 24 to 48 hours rather than immediately. Day two is very often the worst day.
How much swelling depends heavily on the treatment area. Lips swell the most, sometimes dramatically, and the tear trough is not far behind. Cheek fillers, chin and jawline are generally more restrained, and mid-face filler tends to settle faster than people expect given how much product is used.
Most swelling settles within three to five days. Some minor puffiness can linger for up to two weeks, particularly under the eyes.
When to be concerned: swelling that is worsening after day three rather than improving, swelling that is hot to the touch, or swelling accompanied by significant pain.
Bruising and redness are normal, and some areas bruise more
The face is well supplied with blood vessels, and a needle passing through them causes bruising. It is not a sign of poor technique, and it is one of the most common side effects of injectables generally, whatever the injectable treatment.
The under-eye bruises most readily, because the skin there is thinnest and the vessels sit close to the surface. Lips are next. Mild redness at each injection site is normal on the day and usually gone by morning. Most bruising fades within five to seven days and covers easily with makeup after the first day.
When to be concerned: a bruise that is spreading rather than fading, or one that is unusually painful.
Lumps and firmness are usually normal
Almost everyone can feel something in the first week or two. Filler needs time to settle and integrate with the surrounding tissue, and in the meantime it can feel firm, slightly uneven, or lumpy to the touch.
Most of this resolves on its own. Resist the urge to press and prod at it, and do not massage anything unless we have specifically told you to.
When to be concerned: a lump that is still clearly visible or palpable after two to four weeks, or one that is growing, painful or discoloured. Those need looking at rather than waiting out. Any sign of infection at an injection site, such as heat, spreading redness or discharge, needs to be seen promptly. If something genuinely has not settled, filler can be dissolved, which is one of the real advantages of hyaluronic acid products.
Separately, filler that appears to have moved from where it was placed is a different issue, and worth raising with us directly rather than waiting.
The signs that mean ring us now
These are rare, but they are the reason we would always rather hear from you.
Call the clinic immediately if you experience:
- Severe or escalating pain, particularly pain that is out of proportion to the treatment
- Skin that turns white, pale or blotchy, or develops a mottled purple pattern
- Skin that feels cold in the treated area
- Any change to your vision
These can indicate that filler has affected a blood vessel. It is uncommon, but it is time-critical, and it is treatable when caught early. Do not wait until morning, do not message and wait for a reply, and do not sit on it hoping it improves.
When you can judge the result
Give it two weeks.
Filler at day two is swollen. Filler at day seven is still settling. What you see at around fourteen days is the actual result, and your facial contours will look softer and more natural than the version that alarmed you on the second morning.
If at that point it is not what you hoped for, tell us. It is much easier to have that conversation than to leave it unsaid, and your treatment review is included, so there is nothing to pay to be seen.
Making it last
How long dermal filler lasts depends more on the product, the area and your own metabolism than on anything you do afterwards. That said, staying hydrated, sun protection and not smoking all help, and daily SPF is the single most useful habit for anyone having facial fillers.
Areas that move a lot, such as the lips, break filler down faster than areas that do not, such as the cheeks. That is normal and worth factoring into your expectations rather than reading as a problem.
It is also worth knowing that different concerns wear differently. Marionette lines and the lower face tend to hold their result well, while lip filler is the shortest-lived of the lot. Your practitioner should tell you what to expect for your particular treatment plan rather than quoting you a single number for everything.
Book a consultation in Newcastle
Every dermal filler treatment at our Team Valley clinic is nurse-led, and you leave with written aftercare and a direct way to reach us if anything concerns you.
Good aftercare starts before the needle, though. A filler result is only ever as good as the assessment behind it, which is why we look at your face properly, talk through what is actually bothering you, and tell you honestly when filler is not the right answer.
You can read more about our full range of dermal fillers in Newcastle, or book a consultation with Nurse Ness Abbey and her team.
