Key facts
- First 24 hours
- No pressing, massage, make-up over entry points, heat, alcohol or hard exercise; cool compress for comfort
- First week
- Keep the area clean; no facials, energy treatments or dental work unless agreed; note product and area used
- Sun
- Avoid strong sun, saunas and steam early on; sunscreen daily on the face
- Sleep
- Face-up with the head raised for the first nights; avoid pressing the treated side into the pillow
- Normal
- Swelling, tenderness, small bruises, temporary asymmetry, firmness that softens as swelling settles
- Same day
- Blanching, dusky or mottled skin, severe or worsening pain; any vision change means A&E immediately
What should you do in the first 24 hours after dermal fillers?
In the first 24 hours after dermal fillers, leave the treated area alone. The product has been placed in a chosen plane by needle or cannula, and pressing, rubbing or massaging it can move it before the tissue has settled around it. A clean, cool compress held lightly for a few minutes at a time eases tenderness and limits swelling; do not press hard and do not apply ice directly to the skin.
Keep the entry points clean and dry. Cleanse gently with lukewarm water and a mild cleanser, pat dry and avoid make-up over the entry points for the first day so bacteria are not carried into them. Avoid alcohol, hot showers on the face, saunas, steam and hard exercise for the rest of the day, because heat and raised blood pressure both widen blood vessels and add to swelling and bruising. Paracetamol is reasonable for tenderness if you can take it; avoid anti-inflammatory painkillers unless the clinic has said otherwise, as they can increase bruising.
Look at the skin over and around the treated area several times during the first day, including before bed. The written aftercare given before you leave names the product, the areas and the plane, and takes priority over this page.
What should you avoid in the first week after dermal fillers?
For the first week, avoid anything that presses, heats or vibrates the treated area. No facials, facial massage, gua sha, microcurrent or at-home devices, no HIFU, radiofrequency or laser over the same zones, and no dental work unless the clinic has agreed, because prolonged wide mouth opening and pressure on the cheeks can shift product and dental procedures carry bacteria into the bloodstream. Tight goggles, helmets and face masks that press on the treated area are worth adjusting.
Do not have the area topped up or adjusted by anyone else in this period, and do not judge the shape until swelling has settled; it settles at different rates on each side, so temporary asymmetry is common and is not a reason to add product. Keep a note of the product name, the areas treated and the date, because any doctor who treats you later needs to know whether what is in the face is hyaluronic acid, which can be dissolved, or a biostimulator such as Radiesse or Ellansé, which cannot.
“Hyaluronidase dissolves hyaluronic acid and nothing else. If someone offers to dissolve Ellanse or Sculptra, they are describing something that does not happen.”
Dr Sin YongOn what hyaluronidase can and cannot reverse
How should you handle sun, make-up, exercise and sleep?
Strong sun, saunas and steam are avoided early on, because heat prolongs swelling and bruising. Sunscreen goes on daily as usual once the entry points have closed, which is usually by the next day; a bruise exposed to the sun can leave a brown mark in Fitzpatrick III to V skin, so cover bruised skin or use sunscreen over it.
Make-up can go on from the next day over intact skin, applied lightly without rubbing, and removed gently. Avoid heavy foundation over entry points that are still open. Light exercise such as walking is fine from the next day; hard exercise, hot classes and anything that leaves the face flushed are better left for a few days until swelling has settled.
Sleep face-up with the head raised on an extra pillow for the first nights. Lying on the treated side presses the product into the pillow while the tissue is still settling and can make swelling look lopsided the next morning. Lips and tear troughs swell more than cheeks, chin or jawline, so plan for that if those areas were treated.
What is normal after dermal fillers, and what is not?
Normal after dermal fillers is swelling and tenderness over the treated area, small bruises at the entry points, a feeling of firmness or of the product being palpable in the first days, and some asymmetry while swelling settles at different rates. Lips and tear troughs swell more than bony areas. These settle on their own and are covered in the written aftercare.
Not normal is anything that suggests the blood supply to the skin is affected. Skin that turns white over or near the injected area, or that develops a dusky, purple, blue or net-like mottling, and pain that is severe or getting worse rather than settling, can mean filler is pressing on or inside an artery. This is vascular occlusion and it is time-critical: it needs assessment the same day, not at the next routine review. Any change in vision after filler, including blurring, double vision, loss of vision or pain in or around the eye, is an emergency, and so are signs of a stroke or swelling of the lips, tongue or throat with difficulty breathing.
Other signs that need review rather than emergency care are a lump that is growing, hard or painful, increasing redness, warmth or pus at an entry point, a bluish tint through thin skin, or product that seems to have moved. Nodules can also appear months or years later and need examination rather than massage. For hyaluronic acid filler, hyaluronidase can dissolve misplaced product after examination; it has no effect on Radiesse, Ellansé or Sculptra.
When should you call the clinic after dermal fillers?
Contact the clinic on +65 8023 7170 during clinic hours (Monday to Friday 10am to 8pm, Saturday 11am to 3pm), and say that it is urgent, if you notice any of the following:
Skin turning white, or developing a dusky, purple, blue or net-like discolouration, over or near the treated area.
Pain that is severe, or that is getting worse hours or days after treatment instead of settling.
Swelling that keeps increasing, or an area that becomes hot, red and tender.
A lump that is growing, hard or painful, or pus at an entry point.
A heavy or drooping feeling in the treated area that is not explained by swelling.
Go straight to the nearest hospital emergency department, or call 995, for any change in vision, new facial weakness, slurred speech or weakness of a limb, or swelling of the lips, tongue or throat with difficulty breathing. Do not travel to the clinic first and do not wait for a message reply. Outside clinic hours, blanching, mottling or worsening pain also go to a doctor the same day. The complication care page sets these signs out in full.
What happens at the review, and what if you were treated elsewhere?
The review is timed for after swelling has settled, which is when the shape can be judged. Dr Sin Yong examines the treated areas at rest and in movement, checks the entry points, and compares the face with the photographs in your medical record. The dermal fillers page explains why material, area and plane are chosen before product, and the volume restoration page explains why lifting is sometimes planned before volume so that filler covers just the deficit that remains.
If you were injected at another clinic, the warning signs on this page apply in exactly the same way. For urgent signs, contact the clinic that treated you, another doctor or an emergency department the same day. For anything that is not urgent, such as filler that looks heavy, has moved or feels lumpy, an assessment can be arranged here through filler correction; bring the product name, areas and dates if you have them, because knowing what is there changes what can be done.
