Before surgery: what to prepare
Stop aspirin, ibuprofen, naproxen, fish oil, vitamin E, ginseng, and ginkgo for 5–7 days before to reduce bruising (vitamin C does not need to be stopped for filler, the bleeding-risk evidence is weak). Skip alcohol for 24 hours before. Avoid scheduling filler within 2 weeks of a major event; allow time for swelling to resolve and any touch-ups to settle. Before booking, verify the clinic keeps hyaluronidase on-site as a same-day reversal drug, any reputable Gangnam injector will have it within arm's reach, and a clinic that does not is one to avoid. If you are flying in for treatment, do not fly out within 48–72 hours of injection: cabin pressure changes can worsen swelling, and you want to be on the ground and reachable for the window where a vascular complication is most treatable. If you have a history of cold sores around the mouth and are getting lip filler, ask the clinic about prophylactic antiviral medication; needle trauma can trigger an outbreak.
The day of surgery
Filler is performed in clinic with topical numbing cream and sometimes a dental block for the lips, takes 20–45 minutes depending on areas treated, and you walk out immediately. Mild pinpoint bleeding at the injection sites stops within minutes. Light bruising can appear at any injection site, more commonly with sharp-needle technique than with blunt cannulas (cannulas push vessels aside rather than piercing them, which is why they are associated with both lower bruising rates and lower vascular-injury rates) and more commonly in patients on blood-thinning supplements.
Days 1–3: peak swelling
Swelling peaks day 1–2 for lips (which can look significantly over-volumized, this is temporary), days 2–3 for under-eyes, and is minimal for cheeks or jawline. Cold compresses on the treated area for the first few hours. Avoid heat, alcohol, and strenuous exercise for 24 hours. Do not massage or press the area unless the surgeon specifically instructed you to. Mild tenderness is normal.
Week 1: stitches out, bruising fades
Swelling drops noticeably by day 3–5 and is mostly gone by day 7. The filler begins to integrate with the surrounding tissue. Bruises, where present, fade through week 1.
Weeks 2–4: back to public
Final settled look by week 2 for most areas. Filler softens slightly in the first 4 weeks and stops looking newly placed. The 2-week follow-up is when any asymmetry or under-correction is assessed and touch-ups added.
Months 2–3: swelling resolves
Result remains stable. The filler is fully integrated and indistinguishable from the surrounding tissue to the touch.
Months 6–12: the final result
Filler reabsorption begins around month 6 for lip products, month 9–12 for cheek and chin products, and month 12–18 for the heaviest cheek and jawline products. The reabsorption is gradual, you don't suddenly lose volume; it slowly fades. Repeat treatment is scheduled when the volume has dropped to about 50% of the original placement, which is when most patients feel the desire to refresh.
Red flags: when to call the clinic
Vascular occlusion (filler injected into or compressing a blood vessel) is the emergency you are watching for, and the reversal window is short: hyaluronidase should ideally be given within 60–90 minutes of the first sign of ischemia to maximize tissue salvage. The earliest signs are skin blanching (the treated area turns white or pale, sometimes only briefly) and livedo reticularis (a purple, net-like or mottled pattern across the skin), these can appear before the more obvious blue or dusky discolouration and the more obvious pain. Highest-risk zones are the glabella (between the eyebrows) and nasal dorsum, where retrograde embolism can cause permanent blindness, and the nasolabial folds (angular artery) and tear troughs (infraorbital artery). Call the clinic the same hour for: sudden severe pain at the injection site, skin blanching or a mottled purple net pattern, skin turning blue or dusky, vision changes after under-eye or glabella filler, or sudden severe one-sided headache. Go to an emergency room immediately for sudden vision loss, severe one-sided weakness, or stroke-like symptoms. Distinguish ischemia (white or mottled skin, severe pain, needs hyaluronidase immediately) from infection (red, hot, gradually worsening swelling over days, needs antibiotics). Routine bruising, swelling in the first 3 days, mild tenderness, and a temporarily over-volumized look (especially in lips) are not red flags.