Dermal filler downtime:
swelling and bruising by area, what is not normal, and the rules for make-up and exercise

What happens on the day of dermal fillers?

On the day of dermal fillers the treated area looks a little swollen, feels tender at the entry points and may show a bruise where a needle crossed a small vessel. The surface is intact, so there is no wound to dress, and most people return to ordinary activity the same day.

Leave the area alone: a clean cool compress held lightly for tenderness, gentle cleansing, and no pressing, rubbing or massaging, because product can be moved before the tissue has settled.

How do swelling and bruising differ by area?

Where the filler went decides what recovery looks like. The lips swell most, because the tissue is loose, mobile and richly supplied with vessels; they can look larger and uneven early, and a bruise shows readily through thin lip skin. The tear trough is the other area that puffs, and bruising is more likely there because the skin is thin and the vessels are close to the surface; a bluish tint where hyaluronic acid sits too close to the surface, the Tyndall effect, is a different matter from a bruise. The cheeks, chin and jawline behave differently: product is placed deep, often on bone, so the main sensation is firmness and pressure rather than visible puffiness.

On the nose, where Dr Sin Yong usually places calcium hydroxylapatite or polycaprolactone with a fine needle on the bone, the bridge can look slightly wider and pinker while swelling settles; it is also the zone where the warning signs below matter most. With Sculptra the day-one fullness is largely water and recedes; with Ellansé a temporary firmness sits where the gel is.

“Swelling settles on its own schedule, and never the same on both sides. The shape you see in the first days is not the shape I placed, so I do not judge it yet, and neither should you.”

Dr Sin YongOn judging a filler result too early

What do the following days look like?

Swelling recedes and a bruise fades, but not symmetrically: it settles at different rates on each side and in different areas, so a lip that looks fuller on one side, or a cheek that seems higher than its partner, is common in this phase and is not a reason to add product.

Until then: no facials, massage, gua sha or at-home devices over the treated zones, no HIFU, radiofrequency or laser over the same areas, and no dental work unless the clinic has agreed, because prolonged mouth opening and pressure can shift product. The shape is judged at review, once swelling has settled.

What is not normal after dermal fillers, and when should you call?

Not normal: skin that blanches white, turns dusky, purple or net-like, and pain that is out of proportion to the injection or is getting worse rather than settling. These are the warning signs of a vascular occlusion, in which product blocks or presses on an artery and the skin it supplies is short of blood. A bruise is blue or purple, sits where the needle went in and is tender but not disproportionately painful; an occlusion follows the territory of an artery, hurts more than it should and worsens over hours.

Any change in vision, pain in or around the eye, new facial weakness or slurred speech is an emergency: go to the nearest hospital emergency department or call 995. For skin signs only, contact the clinic the same day in clinic hours; outside them, go to the emergency department. For hyaluronic acid the treatment is urgent, high-dose hyaluronidase, kept in the room wherever it is injected; the non-hyaluronic materials cannot be dissolved, which is why they are placed conservatively. Swelling that increases instead of settling, an area that becomes hot, red and increasingly painful, a cold sore flare or a tender lump appearing well after treatment also warrant a call. The complication care page sets out the same sequence in short form.

Can I wear make-up, exercise and go in the sun after fillers?

Make-up can go on over intact skin once the entry points have closed; avoid heavy foundation over an entry point that is still open. Exercise returns in stages: walking and light activity first, and hard exercise, hot classes, saunas, steam and very hot showers later, once swelling has settled, because heat and raised blood pressure widen blood vessels and add to swelling and bruising.

Sun protection applies throughout: 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 once the entry points have closed. For events, plan around the lips and tear troughs, and keep a note of the product name, areas and date for any doctor who treats you later. The full rules are on the dermal filler aftercare page; flying after treatment covers travel.