Facial Fillers

Most hyaluronic acid fillers last 6–18 months, depending on the product used and the area treated. Areas with more movement, such as the lips, may metabolize filler faster than structural areas like the cheeks.

Most patients report only mild discomfort during dermal filler injections and are pleasantly surprised by how tolerable the treatment is.

At Jacobson Cosmetic Surgery, we use a compounded topical numbing cream prior to treatment that is typically applied for about 5–10 minutes before injections begin. This significantly improves comfort during the procedure.

In addition, many dermal fillers contain lidocaine — a built-in numbing medication within the filler itself — which helps maintain comfort and numb the area as treatment progresses.

Dr. Jessica Jacobson also uses advanced injection techniques designed to minimize discomfort, bruising, and swelling while creating natural, balanced results. Many patients who have previously had filler elsewhere without numbing are especially surprised at how comfortable the experience can be with proper preparation and technique.

There is minimal downtime after dermal filler injections, and most patients return to normal daily activities the same day.

However, it is very normal to experience temporary swelling, firmness, bruising, or small areas of lumpiness immediately after treatment. This early swelling is often a combination of:

• The filler product itself attracting and drawing in fluid
• Localized inflammation from the injection process
• Bruising
• The numbing medication (lidocaine) contained within many fillers

In most cases, swelling is most noticeable during the first 24 hours after injection and then gradually softens and improves over the next several days as the filler settles into the tissues.

Certain areas are naturally more prone to swelling and bruising than others. Lip filler and more superficial fillers tend to swell more noticeably, while deeper structural fillers placed in areas such as the cheeks or jawline typically have less visible swelling and downtime.

It is also common for filler to feel slightly firm or uneven initially. This generally improves as swelling resolves and the product integrates naturally into the tissue over the following days to weeks. Final results are best evaluated once the filler has fully settled.

One of the benefits of dermal filler treatment is that results are visible immediately after your appointment. You will notice instant improvement in volume, contour, and facial balance as soon as the filler is placed.

However, it is important to understand that your “day one” appearance is not your final result. Immediately after treatment, there is often a combination of:

• Swelling
• Mild inflammation
• Temporary firmness
• Bruising
• Fluid retention from the filler itself
• Swelling from the lidocaine contained within many fillers

For this reason, the treated area may initially appear fuller, firmer, or slightly uneven compared to the final healed outcome.

Swelling is typically most noticeable during the first 24–48 hours and then gradually improves over the following several days. Areas such as the lips are especially prone to swelling and bruising, while deeper filler treatments in the cheeks or jawline often have less visible downtime.

Most filler treatments begin looking softer and more natural within the first week, with final results generally settling over 1–2 weeks as swelling resolves and the product integrates naturally into the tissues. At that point, the filler’s true shape, contour, and balance can be more accurately assessed.

When performed by a qualified physician with extensive knowledge of facial anatomy, dermal fillers are considered very safe and effective. At Jacobson Cosmetic Surgery, all injectable treatments are performed personally by Dr. Jessica Jacobson to help ensure precise placement, natural-looking results, and patient safety.

As with any injectable treatment, however, there are always potential risks and side effects. Common temporary side effects include:

• Swelling
• Bruising
• Redness
• Tenderness
• Minor bleeding at the injection site

More serious — but rare — complications can also occur, including vascular occlusion. This happens when filler is unintentionally injected into or compresses a blood vessel, reducing blood flow to the surrounding tissue. If not recognized and treated promptly, vascular occlusion can potentially lead to skin injury or tissue damage.

For this reason, choosing an experienced injector with advanced understanding of facial anatomy, vascular patterns, and complication management is extremely important. Dr. Jacobson uses careful injection techniques, detailed anatomical knowledge, and appropriate safety protocols to minimize risk and monitor patients closely throughout treatment.

During your consultation, risks, benefits, expected recovery, and safety considerations will all be reviewed thoroughly so you can make an informed decision about treatment.

To help minimize bruising and swelling after facial filler injections, we generally recommend avoiding blood-thinning medications and supplements for approximately one week before treatment when medically appropriate and approved by your prescribing physician.

These may include:

• Aspirin
• Ibuprofen (Advil, Motrin)
• Fish oil/Omega-3 supplements
• Vitamin E
• Certain herbal supplements such as ginkgo biloba, garlic supplements, turmeric, and St. John’s Wort
• Excessive alcohol intake in the 24–48 hours prior to treatment

These substances can increase the likelihood of bruising, bleeding, and swelling at the injection sites.

We also recommend arriving well-hydrated and avoiding scheduling filler immediately before major events, vacations, weddings, or photoshoots, as temporary swelling or bruising can occur while the filler settles.

Please do not stop any prescribed blood-thinning medications without first discussing it with your prescribing physician. During your consultation at Jacobson Cosmetic Surgery, Dr. Jessica Jacobson will review your medical history, medications, and supplements to help optimize both safety and results.

First — don’t panic! Mild bruising is a very common and normal side effect after injectable treatments, especially in delicate facial areas such as the lips.

At Jacobson Cosmetic Surgery, we provide ice packs after treatment to help minimize swelling and bruising. Applying ice intermittently during the first 24 hours can be very helpful.

To help reduce bruising and prevent worsening, we also recommend:

• Avoiding blood-thinning medications and supplements for approximately one week after injections when medically appropriate
• Avoiding strenuous exercise for 24 hours
• Limiting alcohol intake immediately after treatment

Helpful blood-thinning agents to avoid may include:

• Aspirin
• Ibuprofen
• Fish oil/Omega-3 supplements
• Vitamin E
• Certain herbal supplements

We also recommend topical and oral arnica, a natural herbal supplement commonly used to help minimize bruising and swelling. We carry the Silagen® bruise care line in our office specifically for this purpose, and all of our post-lip “chapstick” aftercare products contain arnica to support healing and comfort after injections.

Most bruising improves significantly over several days and can often be covered with makeup once the injection sites have closed.

Yes — in many cases, hyaluronic acid (HA) fillers can be dissolved if needed. This is one of the reasons HA fillers are so popular and versatile.

A medication called hyaluronidase is injected into the treated area to break down and dissolve the filler. Hyaluronidase is an enzyme that naturally breaks apart hyaluronic acid, allowing the body to gradually reabsorb the filler material.

Patients may choose to dissolve filler for a variety of reasons, including:

• Wanting a more natural or less full appearance
• Filler migration
• Asymmetry
• Lumpiness or irregularity
• Swelling that persists
• Unsatisfactory cosmetic results
• Rare vascular complications requiring urgent treatment

The dissolving process itself is typically quick and performed in the office. Depending on the amount and type of filler present, some patients may require more than one dissolving session to achieve the desired result.

It is also important to understand that hyaluronidase can dissolve both filler and some of your body’s own naturally occurring hyaluronic acid temporarily, so there may be a period where the area appears flatter or slightly deflated before tissues rebalance and heal.

Some swelling, tenderness, or bruising can occur after dissolving injections, but recovery is generally minimal. In many cases, patients may choose to refill or reshape the area after the tissues have settled appropriately.

During your consultation at Jacobson Cosmetic Surgery, Dr. Jessica Jacobson can evaluate your current filler, discuss whether it is dissolvable, and create a personalized plan to help you achieve a balanced, natural-looking result.