What recovery genuinely looks like
The phrase no downtime appears on a great many pages selling this treatment. It is not accurate for most people, and planning on it is how people end up at events looking swollen.
Expect small raised bumps at each injection point immediately afterwards, which usually settle within hours to a day. Expect some redness. Expect bruising to be a real possibility, particularly around the eyes, on the neck and on the hands, and expect it to last several days if it occurs. Expect tenderness. Expect the treated area to feel and look slightly swollen for a day or two, and longer around the eyes.
What is not expected: increasing rather than decreasing pain, spreading redness and heat, fever, discharge, blanching or mottling of the skin, or any change in vision. Those need attention rather than patience, and the article on complications sets out what to do.
3.4.1The first few hours
Immediately after treatment the injection points are usually visible as small raised areas, sometimes described as blebs, at each site. The area is pink. It feels tender and slightly tight. For most people the raised points settle within a few hours as the fluid disperses, and the redness fades over a similar period.
This is the period in which people most often regret having booked something for the same evening. The realistic advice is to treat the day of treatment as a day when you would rather not be photographed and would rather not meet anyone you are trying to impress.
3.4.2Days one to three
Residual swelling, particularly around the eyes and mouth, is normal in this window and is more noticeable first thing in the morning. Tenderness to touch is normal. Bruising, if it is going to appear, generally shows within this period and then follows the ordinary course of a bruise, changing colour over several days before clearing.
Bruising risk is higher if you take anticoagulants or antiplatelet medication, if you have been drinking alcohol, and in areas with thin skin and prominent vasculature. Anyone taking prescribed anticoagulation should have discussed it at consultation, and should not stop or alter prescribed medication for a cosmetic procedure without the advice of the doctor who prescribed it.
3.4.3The first two weeks
Most visible signs have resolved by the end of the first week for most people in most areas. The periorbital area is the common exception, where residual puffiness can persist noticeably longer.
This is also the period in which people start looking for a result and generally should not. Whatever is happening in the tissue, the early appearance is confounded by residual swelling, and judging the outcome while the area is still settling produces both false optimism and false disappointment. If you have taken standardised photographs, this is the point to leave them alone.
| Area | Visible immediately | Usually settling by | Most likely to surprise you |
|---|---|---|---|
| Cheeks and mid face | Small raised points, pink skin | Same day to next day | Tenderness on touch for a couple of days |
| Periorbital | Raised points, puffiness | Several days, sometimes longer | Morning puffiness that persists past the first week |
| Perioral | Raised points, swelling | One to three days | How conspicuous lip area swelling is socially |
| Neck and decolletage | Raised points, redness | Several days | Bruising that takes a week or more to clear |
| Hands | Raised points, swelling | Several days | Swelling that interferes with rings and grip |
A framework written by this publication to organise a decision. It is not a measurement, it is not drawn from any study, and no figure in it should be quoted as a finding.
3.4.4What varies, and why
Recovery varies far more between people than the marketing suggests, and the variables are mostly not under anyone's control.
- Area. Periorbital and perioral skin swells more and shows it more. Neck and hands bruise more readily and resolve more slowly.
- Technique and number of injection points. More points means more small injuries. Different practitioners use different densities.
- Individual bleeding and bruising tendency. Which varies for reasons including medication, supplements, alcohol and simple constitution.
- Volume placed. More material means more immediate physical swelling.
- Whether anything else was done in the same session. Combined treatments produce combined recoveries.
A practitioner who tells you at consultation what their patients typically experience in your specific area, rather than what the leaflet says, is giving you something usable.
3.4.5Planning around it
The practical advice is straightforward and rarely given. Do not have this treatment in the week before an event that matters to you. If you are having a course, work backwards from the fixed date in your calendar and leave more room than you think you need, because bruising is unpredictable and lasts longer than swelling.
Two weeks of clearance before something important is a reasonable margin for most areas. For the periorbital area, more.
3.4.6What is not normal
The distinction that matters is between something settling and something developing. Ordinary recovery improves day by day. Anything that is getting worse rather than better after the first day deserves attention.
- Pain that increases, or pain out of proportion to what you were told to expect.
- Redness that spreads, with warmth, particularly with fever or feeling unwell. The NHS page on cellulitis describes what a spreading skin infection looks like.
- Discharge or a collection at an injection site.
- Blanching, mottling or a dusky appearance of the skin, especially with pain. This is the presentation associated with a vascular event and is urgent.
- Any change in vision, at any point, after treatment near the eye. Urgent.
- Swelling that is worsening after several days rather than settling.
Contact your practitioner. If you cannot reach them, NHS 111 online is the route for urgent advice, and visual symptoms or severe pain warrant an emergency department rather than a wait.
3.4.7A note on the phrase no downtime
It appears on a great many pages advertising this treatment. Read strictly, it means that there is no period during which you are incapacitated, which is true. Read as most people read it, it means you can go straight back to your life looking normal, which is not reliably true and is particularly not true around the eyes.
Under the CAP Code, advertisers must not mislead by omission or by implication and must not trivialise a procedure. A claim of no downtime made without qualification, for a treatment that commonly produces visible swelling and possible bruising, is the kind of claim that has attracted regulatory attention across the cosmetic sector, and the ASA rulings database is a useful place to see what has already been found unacceptable.
Questions
Can I go back to work the same day?
Most people can, in the sense of being able to function. Whether you will look as you usually do is a different question, and around the eyes and mouth the answer is often no for a day or two. Plan the day of treatment as one where you would rather not be photographed.
How long before an event should I have it?
Leave more room than you think you need. Two weeks is a reasonable margin for most areas and more for the periorbital area, because bruising is unpredictable and outlasts swelling.
Should I stop my blood thinners to reduce bruising?
No. Never stop or alter prescribed anticoagulant or antiplatelet medication for a cosmetic procedure without the advice of the doctor who prescribed it. Tell your practitioner you take it, and accept that bruising is more likely.
When can I judge the result?
Not in the first two weeks, when residual swelling confounds everything. Standardised photographs taken before treatment and again well after the course has finished will tell you more than your memory or an early mirror check.
What should make me call someone?
Anything getting worse rather than better after the first day: increasing pain, spreading redness with warmth, fever, discharge, blanching or mottling of the skin, or any change in vision. Contact your practitioner, and if you cannot reach them use NHS 111, or an emergency department for visual symptoms or severe pain.
- NHS, Cellulitis
- NHS 111 online
- NHS, Plastic surgery
- The UK Advertising Codes, CAP and BCAP
- ASA rulings database
Links to regulators, professional bodies, legislation and research indexes. They are cited because they are public and checkable, not as endorsement of this publication. No source listed here has any commercial relationship with us.
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