Dermal filler aftercare, from day 0 to your review

What filler aftercare involves

Filler aftercare means protecting freshly placed filler from pressure and heat for a day or two, letting swelling settle, and knowing the few warning signs that need prompt attention. Most hyaluronic acid (HA) filler treatments go smoothly, and the commonest after-effects are mild swelling, tenderness and occasional bruising, which settle on their own. A review of filler adverse events describes most reactions as mild and short-lived, such as bruising and swelling from the injections, with serious events rare.

At SkinRev Lab, dermal fillers are a medical treatment performed by Dr Sin Yong after a consultation and examination. Filler is placed in small amounts with a fine needle or a blunt cannula, at a depth chosen for each area: on bone for the chin and cheekbones, in deeper fat for some midface work, and more superficially for lips and fine hollows. That choice affects recovery, which is why aftercare varies a little by area.

The guide below covers the general pattern for HA filler in the face. It applies to areas such as the cheeks, chin, temples, under-eyes and lips. Collagen stimulators behave differently, and Dr Sin Yong gives separate instructions for those. If his instructions on the day differ from this page, follow his, because they are based on the product, depth and area used for you.

Day-by-day timeline after filler

Swelling usually appears within hours, peaks around day one or two, and has largely settled within about a week; by two weeks the shape should be close to the final result. The table shows the usual pattern and when to act.

Typical swelling varies by area. Lips can look uneven or lumpy for several days and usually settle within one to two weeks. Under-eye swelling and bruising can last about a week and sometimes up to two. Cheeks and other areas where filler sits deep on bone are usually milder, often settling within a few days to a week.

The first 24 to 48 hours

For the first day or two, keep the area cool, avoid pressure on it and keep your activity light. Fresh HA gel is soft and the tissues around it are swollen, so pressure, heat and a raised heart rate are the main things to avoid.

• Cold, briefly: a wrapped cold pack for about ten minutes at a time on day one eases swelling and discomfort. Hold it lightly; do not press on fresh filler.
• No pressing or massage: avoid rubbing, massaging or pressing on the treated area unless your doctor specifically asks you to.
• Sleep position: do not lie face-down on the treated area that night. After lip or under-eye filler, sleeping with the head slightly raised for a night or two helps.
• Exercise: avoid strenuous exercise for about 24 hours; a gentle walk is fine.
• Heat and alcohol: avoid saunas, steam, hot yoga and alcohol for a day or two, as they can increase swelling and bruising. Very salty food can also add puffiness.
• Make-up: usually from the next day, once injection points have closed. Use clean brushes and a light touch.
• Pain relief: ask the clinic which painkiller suits you, as aspirin-type painkillers can increase bruising. Do not stop a prescribed medicine without your doctor's advice.

Small bumps at injection points usually settle within hours. Some tenderness when chewing or smiling is common after cheek or chin filler and fades over a few days.

Swelling, bruising and lumps: what is normal

Mild to moderate swelling, tenderness, bruising and slight firmness are normal in the first one to two weeks; swelling that is getting worse, is very one-sided after two weeks, or comes back weeks later should be checked. Knowing the usual pattern helps you avoid both worry and delay.

• Swelling: often worst in the morning and better by the evening. Taking a photo each morning and evening for a week is a useful check: change through the day suggests fluid, while an unchanging shape reflects the filler itself.
• Bruising: most filler bruises fade within about two weeks. A bruise may appear straight away or darken over the first three days. Lips and under-eyes bruise more often than areas treated deep on bone. See bruising after filler for more.
• Firmness or small lumps: slight firmness can be felt for a week or two as the gel integrates. Do not massage lumps on your own; mention them at review.
• Asymmetry: swelling is rarely even, so early asymmetry is common. The result and symmetry are judged at the review, not in the first few days.

Book a check if swelling has not settled after two weeks, keeps returning, is clearly worse on one side, or if a blue-grey tint has not changed after two weeks, as filler can sometimes show through thin skin. A new swelling weeks or months later, sometimes after an illness, dental work or a vaccination, is treated as a reaction until assessed. Filler swelling explains how Dr Sin Yong assesses these.

Warning signs that need same-day care

A few signs after filler need the clinic's attention the same day, and any change in vision is an emergency. These problems are uncommon, but acting quickly matters, so it helps to know them before you leave the clinic.

Contact the treating clinic straight away, even out of hours, if you notice:

• Skin that turns pale, white, dusky or mottled, or develops a net-like pattern.
• Pain that is out of proportion or keeps increasing, rather than easing.
• Skin over or near the treated area that feels cold compared with the other side.
• Spreading redness with heat, pus or fever.

Call 995 or go to a hospital emergency department at once for:

• Any change in vision, including blurring, double vision or loss of vision.
• Eye pain or a drooping eyelid after treatment.
• Rapid swelling of the lips, tongue or throat, or difficulty breathing or swallowing.

The most serious filler complication is a blocked blood vessel (vascular occlusion), when filler enters or presses on an artery. International consensus guidance stresses early recognition, because HA filler can be dissolved with an enzyme (hyaluronidase) as soon as a blockage is suspected. If you cannot reach the clinic, go to the nearest emergency department and tell staff you have had filler, where and when. For SkinRev Lab patients, the WhatsApp line is +65 8266 9585, daily from 11am to 8pm.

Skincare, make-up and sun after filler

You can usually return to your normal skincare the day after filler, as long as you apply products gently and avoid pressing or massaging the treated area. Filler sits beneath the skin, so most products on the surface do not affect it, but the way they are applied can.

• Cleansing: use a mild cleanser and pat dry rather than rubbing, especially over lips, under-eyes and cheeks.
• Moisturiser and sunscreen: fine from day one. Smooth them on lightly with fingertips.
• Make-up: usually from the next day, once injection points have closed. A light concealer can cover a bruise.
• Actives: retinol, exfoliating acids and vitamin C can usually continue from the next day on intact skin. Avoid them on any area with open injection points or irritation.
• Tools: avoid facial rollers, gua sha, cleansing brushes and firm facial massage on treated areas for at least a couple of weeks.
• Sun: keep bruised skin out of strong sun, as sun on a bruise can leave a brown mark in some Asian skin tones. Daily broad-spectrum sunscreen and a hat help.
• Glasses: heavy glasses resting on fresh cheek or nose filler can press on it. Lighter frames or contact lenses for a few days are a sensible precaution, if practical.

If you have sensitive skin or use a prescription cream, ask Dr Sin Yong at your appointment when to restart it. Hats and headbands are fine unless they press on treated temples or forehead.

Exercise, travel, dental work and other treatments

Most people can return to light activity the same day and full exercise after about 24 hours, while facials, massage, lasers and dental work are spaced further out. The main principle is to avoid pressure, heat and inflammation near fresh filler.

• Exercise: avoid strenuous workouts for about 24 hours; avoid hot yoga and saunas for a day or two.
• Massage: book any face-down massage before your filler appointment, or wait a day or two afterwards, as face cradles press on the cheeks.
• HydraFacial and other facials: wait until swelling, bruising and tenderness have settled, usually about two weeks after HA filler, and tell your therapist where the filler was placed. See HydraFacial timing with injectables and lasers.
• Lasers and energy treatments: your doctor will advise the gap. When light-based treatments and HA filler are planned for the same day, the light treatment usually comes first.
• Dental work: dental treatment can introduce bacteria and causes jaw stretching. If dental work is planned, mention it at consultation; your doctor will advise on spacing.
• Flights and travel: travelling soon after filler is usually fine, but book treatment so your review falls before a long trip.
• Events: book at least two weeks before an important event, and well ahead for weddings, so there is time to review and adjust.

Illness, vaccinations and dental infections can occasionally trigger delayed swelling in filled areas. Mention any of these if swelling appears later.

Your review, top-ups and correction

At SkinRev Lab, a review is usually arranged two to four weeks after treatment, once swelling has settled, to judge the result and symmetry. This is when small adjustments are considered, not in the first few days when the area is still swollen.

• Bring your photos: day-by-day photos in the same light help Dr Sin Yong see how the area has changed.
• Small adjustments: if one side needs a little more, it is usually easier to add a small amount at review than to remove excess.
• Too full or uneven: HA filler can usually be dissolved with an enzyme (hyaluronidase) if needed. Dr Sin Yong maps filler by ultrasound before dissolving. See dissolving filler.
• Problems from earlier filler: if you had filler elsewhere and something does not feel right, filler correction starts with an examination and, where useful, ultrasound. See also filler problems.
• Top-ups: HA filler is gradually broken down over many months to a year or more, faster in lips and mobile areas. Top-ups are considered only after the previous filler has visibly softened. See how long fillers last.

Keep a record of the product, amount and areas treated. HA gel can persist in the tissue longer than it appears to, which is why repeat treatments are planned cautiously. Dermal fillers are priced at consultation.

SkinRev Lab's own filler aftercare advice

SkinRev Lab's filler aftercare advice comes down to four points: avoid heavy exercise, saunas, facial massage and pressing on the area for a day or two; do not lie face-down on treated areas that night; expect swelling, tenderness and bruising to settle over several days; and contact the clinic the same day for the warning signs above. This is the same advice published on the dermal fillers treatment page.

1. Before you leave: Dr Sin Yong checks the treated area and explains any area-specific instructions.
2. Day 0 to day 2: no heavy exercise, saunas, facial massage or pressure; no face-down sleeping that night; short spells of a wrapped cold pack if helpful.
3. Days 3 to 14: normal routine; gentle skincare; sunscreen; book a check for anything that is getting worse rather than better.
4. Weeks 2 to 4: review to judge result and symmetry.

If you are unsure whether something is normal, send a clear photo taken in daylight to WhatsApp +65 8266 9585 with a short description and the date of treatment. It is better to ask early than to worry. For the warning signs, do not wait for a reply: contact the clinic directly, or go to an emergency department if your vision changes. SkinRev Lab is at #B1-28 CityLink Mall, 1 Raffles Link, by City Hall MRT, open daily from 11am to 8pm.