Cosmetic injectables are on the rise and with them, telltale side effects like swelling, redness, and bruising. Though less likely with wrinkle-smoothing neurotoxins like Xeomin, volumizing and contouring hyaluronic acid fillers are notorious for leaving their temporary mark. “The art of filler is not always perfect, and patients should definitely concern themselves with potential issues like swelling and bruising in order to prepare for any corrections,” Beverly Hills–based double board-certified plastic surgeon Ben Talei says.
Data shows that post-injection skin concerns are becoming increasingly prevalent as more and more patients opt for injectables. The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) reported a 40 percent increase in the number of surgical and nonsurgical cosmetic procedures in 2022, with board-certified dermatologist Anar Mikailov citing studies that show up to 70 percent of patients report bruising post-filler. “This uptick in aesthetic procedures [means that] preparation and aftercare instructions must be discussed and in place to optimize outcomes,” holistic plastic surgeon Shirley Madhere, who is based in New York, says.
You might be surprised to hear that the right skincare can drastically reduce post-injection side effects—and more sophisticated options are arriving. Clinical results from the new, luxury skincare line Viktor Michael showed a 50 percent reduction in post-injectable downtime after spending six years in meticulous formulation. “The main objective of Viktor Michael is to fill the gap in preventive and post-care for cosmetic injections,” Shay Sim and Nadya Kozlova, cofounders and co-CEOs of Viktor Michael, tell BAZAAR.com. “The majority of patients schedule their injections around their jobs and their spouse’s work schedules, so we wanted to combine what is proven to prevent, support, and treat post-needle side effects.”
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Understanding Post-injectable Downtime
Bruising occurs when the “blood vessels are punctured by the needle,” Calabasas-based celebrity cosmetic injector Jasmine Khachatrian explains. Certain zones of the face are more at risk of visible aftereffects. “Areas with more dense or superficial blood vessels, such as around the mouth, are more likely to bruise with filler placement,” Santa Monica–based board-certified dermatologist R. Sonia Batra says. She also points out that “ibuprofen, supplements like fish oil and vitamin C, or wine and cocktails” all make post-injectable bruising more likely.
Downtime also includes inflammation, which occurs as lymph fluid accumulates around the needle’s point of injection and the foreign substance (the filler). Talei notes that most fillers take roughly two weeks to settle, but that long-term swelling can sometimes occur due to factors like “environmental allergies, water retention, change in filler character over time, and impairment of lymphatic drainage.” Hyaluronic filler is hydrophilic, sometimes attracting lymph fluid that results in long-term discoloration.
Post-Injection Topical Skincare
Anti-inflammatory and pro-healing topical skincare is the next line of defense, after icing, in reducing downtime. Mikailov points out that the bruising begins to form within the first 24 hours, making post-treatment skincare critically important (and leading him to create an award-winning Skintensive Bruise & Scar Cream to stymy bruise proliferation). At Talei’s practice, patients heal using his organic AuraSilk, a blend of 20-plus botanical oils, while Khachatrian’s patients seek relief from CBD and hyaluronic acid in the Kanavia CBD Face Mask.
The Viktor Michael Injection Intervention Duo Pre and Post Injection Care Bundle represents the most comprehensive injectable skincare line to date. It takes the entire “injection cycle” into consideration—beginning use of the serum at least three days prior to injection, then calming and healing the skin post-treatment with continued use and incorporation of the mask. The brand utilized the standards of the Environmental Working Group (EWG) when selecting the actives found in its patent-pending Injection Care Complex, which includes 15 percent Arnica montana (double the strength of a typical drugstore arnica cream), anti-inflammatory bromelain to reduce redness and inflammation, wound-healing dragon’s blood sourced from tree sap, and babassu palm oil for soothing. “The last thing we want to do is add bad ingredients to the fragile, healing skin,” Kozlova says.
After six years of testing the products on themselves and their patients, Sim and Kozlova put Hidden Agenda Pre & Post Care Serum and the cooling Ciao for Now Post Care Mask to the test in a clinical trial with 40 participants familiar with cosmetic injections. By day nine, 92 percent agreed that their downtime had been cut in half, 97 percent reported reduced swelling and bruising, and 100 percent deemed the duo the best post-injection products they had ever used.
How to Care for Skin After Filler
There are other things you can do to expedite the healing process aside from applying topical skincare. Mikailov advises icing immediately to decrease inflammation, with the ultra-convenient Melissa Imperial Cryo Facial Ice Popsicle and the cooling Velez by Vesna Intense Hydration Face Mask being excellent at-home options for soothing. In-office cryotherapy treatments, like the five-minute CryoTouch device offered by celebrity aesthetician Sarah Ford or the GlacialGlide at Batra’s practice, also quell redness and inflammation.
“The use of lymphatic drainage massage along with transdermal ultrasound therapy has demonstrated substantial improvement in swelling,” Talei says of the manual technique to facilitate the body’s innate healing process. Celebrity aesthetician Melissa Imperial uses both these modalities in her facials (specifically, the Manual Lymph Drainage method developed by the French doctors Emil and Estrid Vodder) with a lymph-stimulating herbal poultice, facial cupping, LED, and microcurrent to sculpt, lift, and de-puff her celebrity clients.
Beverly Hills–based integrative aesthetics doctor Rahi Sarbaziha loves using healing exosomes and notes that specific wavelengths of LED light decrease swelling to promote localized healing post-treatment. LED devices work by “charging” the skin cells with adenosine triphosphate (ATP) to perform their functions, including the healing, pro-collagen effect of red light and the anti-inflammatory relief of near infrared light (NIR). In-office, you can opt for a professional-grade treatment via LightStim or Celluma (which Ford recommends using on the Aches & Pains setting for the deepest penetration). However, brands also offer FDA-approved devices for the home, like the Shani Darden by Déesse Pro LED Light Mask or the CurrentBody Skin LED Lip Perfector, which is perfect following lip injections.
Sarbaziha has her patients begin taking Dr. Rahi Post-Procedure Recovery supplements three to four days prior to their appointments. “My post-care supplements include bromelain and papain, inositol, amylase and lipase, which works as both a digestive enzyme and breaks down the swelling and bruising in the body, as well as an oral arnica,” she says. “As much as I love oral bromelain, eating fresh pineapple directly is more beneficial as you also get vitamin C, another important vitamin in the healing process.”
Batra adds that avoiding alcohol and activities that will open the blood vessels—namely, intense exercise, taking long hot showers, or going in the sauna or steam room—is important for two days post-procedure.
