Tear trough fillers are a type of dermal filler treatment designed to address the hollowness, or tear trough deformity, beneath the eyes. The treatment involves injecting a hyaluronic acid-based gel to restore lost volume and smooth the transition between the lower eyelid and the cheek. While this procedure is generally safe, the most common side effect is bruising and swelling at the injection sites. This article provides clear expectations regarding how long bruising lasts and how it can be managed.
Why Tear Trough Fillers Often Cause Bruising
The under-eye area is highly susceptible to bruising due to its unique anatomical structure. The skin in this region is the thinnest on the entire face, offering minimal cushioning over the underlying blood vessels. This means that even a minor puncture from a needle or cannula can easily damage the tiny blood vessels, known as capillaries, located just beneath the surface.
When a blood vessel is compromised during the injection process, blood leaks into the surrounding soft tissue, resulting in the visible discoloration known as a bruise. Injecting in this area often requires placing the filler deep near the orbital bone, and even the most skilled practitioners can inadvertently disrupt these delicate vessels. Factors such as individual skin characteristics, the density of blood vessels, and the use of fine needles or blunt-tipped cannulas all influence the likelihood and severity of the resulting bruise.
The Typical Bruising Timeline: What to Expect Daily
The duration of bruising after tear trough filler typically ranges from one to two weeks, although some individuals may notice residual discoloration for up to three weeks. Immediately following the procedure, the area will likely show an initial red or purplish mark at the injection site, accompanied by mild to moderate swelling. Swelling usually peaks within the first 24 to 48 hours.
The bruise then begins its typical color progression as the body breaks down the leaked hemoglobin. By days three through six, the color often deepens, turning a darker blue or black. During the second half of the first week, the color starts to shift, changing to green, then yellow, and finally a light brown as the bruise fades. While swelling often starts to significantly subside after the first three to seven days, the full color resolution of the bruise generally takes closer to the two-week mark.
Strategies for Reducing Bruising and Swelling
Pre-Procedure Care
Minimizing bruising begins before the procedure by avoiding substances that thin the blood. Patients are typically advised to stop taking non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen, as well as supplements such as fish oil, Vitamin E, and Ginkgo biloba, for about seven to ten days prior to their appointment. Alcohol consumption should also be avoided for at least 24 hours before the treatment, as it can contribute to increased bleeding and swelling.
Post-Procedure Care
Post-procedure care is focused on constricting blood vessels and encouraging the reabsorption of leaked blood. Applying a clean, cold compress or ice pack to the treated area for ten to fifteen minutes every hour during the first 24 hours helps to minimize swelling and limit the size of the bruise. Keeping the head elevated, especially while sleeping, for the first few nights promotes lymphatic drainage and reduces fluid accumulation in the under-eye area. Some practitioners also recommend the use of topical treatments containing arnica or oral supplements like bromelain, which may help speed up the bruise’s resolution.
Recognizing Serious Post-Procedure Complications
While minor bruising and swelling are expected, it is important to distinguish these common side effects from signs of a serious complication, such as vascular occlusion. Vascular occlusion is a rare but severe event that occurs when the filler material is inadvertently injected into or compresses a blood vessel, restricting blood flow. This can potentially lead to tissue damage or, in rare cases, vision changes or blindness.
Immediate medical attention is required if a patient experiences any of the following warning signs:
- Severe, disproportionate pain that worsens over time.
- Skin blanching, where the treated area turns white or mottled, indicating a lack of blood supply.
- Any sudden change in vision, such as blurriness or loss of sight.
- A rapidly expanding hematoma, which is a collection of blood that causes sudden, significant swelling.