Lip injections, typically using dermal fillers like hyaluronic acid, are a common cosmetic procedure for enhancing lip volume and contour. Swelling is a temporary and unavoidable part of recovery, representing the body’s natural inflammatory response to needle trauma and the introduction of a foreign substance. While initial puffiness subsides quickly, the final, settled results take a longer period to fully emerge.
The Typical Swelling Timeline
Swelling begins immediately after the procedure due to needle punctures and the hydrophilic nature of hyaluronic acid, which attracts water molecules. The most significant swelling, known as peak swelling, develops over the next 24 to 48 hours. During this time, the lips may appear significantly larger, firmer, and even asymmetrical, often looking much bigger than the desired final result.
Around Day 3, the intense puffiness begins to decrease noticeably as the body resolves the initial inflammatory response. By the end of the first week (Day 5 to Day 7), visible swelling has generally subsided by 50 to 70 percent, and the lips feel much more natural. Most patients can appreciate the improved shape and volume at this point, though minor residual puffiness may still be present.
The final phase of resolution occurs over the next week, with most patients seeing their final results around the 10- to 14-day mark. At two weeks post-injection, nearly all swelling and bruising should be fully resolved, and the filler will have integrated into the lip tissue. The two-week point is the standard time for final assessment.
Factors That Influence Swelling
The intensity and duration of swelling are highly individual. The specific type and viscosity of the dermal filler used play a role, as certain hyaluronic acid products are formulated to be more water-attracting, temporarily increasing post-procedure swelling. Additionally, the quantity of filler injected and the number of needle passes contribute to the degree of trauma sustained by the lip tissue.
A more extensive treatment involving a larger volume of filler or multiple injection points results in a greater inflammatory response and a longer recovery period. The injector’s technique is also a factor; methods that minimize tissue disruption, such as using a cannula, often result in less bruising and inflammation. Individual patient factors, including metabolism and propensity for inflammation, also affect the swelling response.
Managing Swelling and Bruising
Patients can take proactive steps to minimize discomfort and accelerate the resolution of swelling and bruising. Applying a clean, wrapped ice pack gently to the lips intermittently for the first 24 to 48 hours helps constrict blood vessels, reducing swelling and bruising risk. Ensure the ice is not applied directly to the skin to prevent injury.
For the first 48 hours, avoid strenuous exercise, as elevated blood pressure can worsen swelling. Patients should also avoid excessive heat exposure, such as saunas or hot tubs, for at least 72 hours. Recovery is also affected by dietary and medication choices.
Recovery Recommendations
To manage swelling and support healing, patients should follow several recommendations:
- Avoid blood-thinning medications like aspirin and ibuprofen, as well as alcohol, which can increase bruising.
- Sleep with the head slightly elevated using an extra pillow to promote fluid drainage and reduce morning swelling.
- Stay well-hydrated by drinking plenty of water to support the body’s healing process.
- Avoid high-sodium foods, as salt contributes to fluid retention and puffiness.
Recognizing Abnormal Symptoms
While mild to moderate swelling, bruising, and a temporary firm sensation are expected, certain symptoms require immediate medical attention. Severe, disproportionate pain that intensifies after the first 48 hours is a warning sign. Pain that feels sharp, throbbing, or is accompanied by heavy pressure may indicate compromised blood flow.
A serious concern is a change in skin color near the injection site, such as a pale, white, mottled, or dusky, bluish discoloration. This discoloration, often with pain, can signal a vascular occlusion, where filler has blocked a blood vessel, leading to tissue distress. Signs of infection, though rare, include increasing redness, warmth, pus, or a fever.
Persistent, hard lumps or nodules that do not resolve after the two-week mark require evaluation from the provider. Additionally, a rapidly spreading rash, intense itching, or swelling that extends well beyond the treated area could suggest an allergic reaction. Immediate contact with the practitioner or an emergency room is necessary if any concerning symptoms appear.