Lip Filler Swelling Stages: What Is Normal

Dermal filler injections are a very common non-surgical cosmetic procedure –– and the lips are a popular spot for these injections to give you a fuller, plumper pout.

While the procedure is safe when performed by a reputable board-certified dermatologist or cosmetic surgeon, there are still risks to inform yourself about, including the potential for swelling after the procedure.

Here's what you need to know about swelling after getting lip filler, how to care for your swelling, and when to see your doctor.

Keeping in mind that everybody is different, here's what to expect after getting filler injected:Immediately after/day of: Mild to moderate swelling can occur within minutes, says Dr. Melanie Palm, MD, a double board-certified dermatologist and cosmetic surgeon at Art of Skin MD and an assistant clinical professor at the University of California, San Diego.

This swelling can look a little wonky. "Although hyaluronic acid dermal fillers produce immediate results, the swelling can be uneven at first and hide the true results of the lip fillers," says Dr. Michele Green, a board-certified dermatologist in private practice.

One day afer: Green says for many people, inflammation is the most severe on the day after the lip filler injections.

"The lips will appear larger than anticipated, which can cause anxiety. Don't worry. The swelling is temporary, and the size of your lips will decrease with time," Green says.

Bruising and tenderness may crop up on the day after, too.

Two days after: Two days after your injections, your lips may still be a little swollen, sensitive, and bruised. "The lips may feel 'bumpy,' which is normal and temporary as the swelling subsides and the fillers settle into the lips," Green says.

Three days after and beyond: You should certainly notice a decrease in swelling by the third day. "There will be an improvement in swelling and bruising each day following the injections, and the appearance and feel of the lips will improve over time," Green says.

At the longest, it can take a week for swelling to completely subside, but it really depends on the individual, says Green.

Swelling and inflammation are your body's natural response to minor trauma caused by injections, says Green.

"When the body detects damage, the immune system sends fluid and white blood cells to the injured area, causing swelling, redness, and heat from the increased blood flow. Because the lips have a lot of blood vessels, the inflammation tends to be worse than in other areas where fillers are injected," Green says.

The type of filler you get may also contribute to the level of swelling you experience. Hyaluronic acid (HA) fillers can make you more prone to swelling, since hyaluronic acid particles act like magnets to water, attracting 1,000 times their molecular weight in water, says Palm.

Juvéderm and Restylane are two of the most commonly used lip fillers –– both of which are HA based.

Everyone will experience swelling differently after getting fillers. Palm says some peoples' swelling may last hours, while others' may last for days.

Setting yourself up for successful healing and aftercare starts before you get your procedure done, and it's crucial that you follow your doctor's instructions once you get home to ensure the best results.

Here's what you can do before your appointment to reduce swelling:

1. Avoid blood thinners

Blood thinners can inhibit your healing. Green says you should avoid blood thinning agents such as NSAIDs like Advil, Aleve, Motrin, and Naproxen 10 to 14 days before getting filler.

If you take a prescription blood thinner or take OTC blood thinners for certain health conditions, check with your doctor on this, first.

2. Avoid certain supplements

Green says some supplements can increase your risk of bleeding and swelling, such as fish oil, vitamin E, garlic, and ginkgo Biloba. You should also avoid these for 10 to 14 days before your procedure.

3. Avoid alcohol

Since alcohol is a vasodilator, it can increase your risk of bruising and swelling –– so you should avoid it at least 48 hours before getting filler, Green says.

4. Take an antihistamine

Palm advises her patients to take a third-generation antihistamine (an allergy medication) such as Zyrtec several days before their appointment.

"Antihistamines reduce histamine and mast cell degranulation, which are the primary factors causing swelling related to lip filler placement," Palm says.

5. Use a peptide serum

There are products made specifically for injection aftercare. A 2020 study Palm helped conduct found that using a peptide serum can reduce the time of bruising and swelling.

"I recommend Alastin Enhance to be applied topically two to three times per day. This can be started several days prior to the patient's appointment, and continued until bruising and swelling have subsided," Palm says.

6. Use arnica

Arnica is a supplement available in topical or oral forms that can lessen inflammation and bruising. "Arnica tablets can be started two days prior to the injections, continuing after the treatment to facilitate the healing process," Green says.

Here's what you can do after your appointment to reduce swelling:

1. Apply ice

"Immediately after the injections, an ice pack or cold pack is applied to the injected area to minimize the swelling and bruising. The cold temperature causes vasoconstriction and is an easy and effective way to reduce swelling," Green says.

You can lightly ice the area for up to 48 hours following filler placement, but be sure to wrap any ice pack in paper towels or a towel to avoid injury to the skin, says Palm.

2. Avoid excessive heat

Since swelling increases with exposure to heat, you should avoid heated environments such as saunas or hot yoga classes, Green says. For best results, avoid this for at least 24 hours.

3. Avoid strenuous exercise

Green says elevated blood pressure and heart rate can increase blood flow and worsen swelling and bruising. To be safe, avoid strenuous exercise for at least 24 hours.

4. Keep your head elevated

Patients should try and maintain their head above heart level, otherwise swelling may be exacerbated," Palm says. It can help to sleep with an extra pillow at night to elevate your head and decrease swelling.

5. Avoid excessive use of your lips

While your lips are healing, take it easy. Avoid using a straw, applying lip makeup, or puckering your lips. This means you should avoid kissing for a few days, too, says Palm.

6. Do not over-massage your lips:Avoid over-massaging your injection sites. "Moderate to severe pressure and manipulation in the area not only can move the filler but also may exacerbate any existing swelling," Palm says.

Closely monitor your lips after getting filler to assess pain and appearance. As a general rule of thumb, Palm says that you should report increasing pain, swelling, or unusual pain to your doctor. "Although there is some discomfort involved in lip filler placement, this should not continue dramatically following lip filler placement," Palm says.

You should also be on the lookout for a purple, lacy pattern of bruising. This could mean that a blood vessel has been compressed, or that filler has gotten into a blood vessel and is blocking circulation to the lip or surrounding tissue, says Palm. This complication is rare but needs to be identified early.

Luckily, there is a solution in these situations if the lips are filled with a hyaluronic acid based filler. Palm says you can reverse this by injecting the lips with hyaluronidase, an enzyme that dissolves the filler.

"Reversal of the filler and supportive care with early intervention can avoid a major complication," Palm says.

In other cases of extreme swelling, Palm says your doctor may prescribe an oral steroid.

Some swelling is to be expected after getting lip filler, especially during the day after. After that, the swelling should subside bit by bit every day, and you'll have a better idea of how your new lips will look. Follow prep and aftercare instructions to minimize your risk of swelling and bruising.

If you have increased pain, bruising, or excess swelling after getting your fillers, contact your doctor immediately for assistance and next steps to ensure your safety and best results.