After getting dermal filler, the first 48 hours are the most important for protecting your results. Most side effects like swelling and bruising are normal, but how you care for the treated area during recovery directly affects how your filler looks once it settles. Here’s what to do (and avoid) in the days and weeks following your appointment.
The First 24 Hours
The single most important rule for the first day: don’t touch your face. Pressing, massaging, or even absentmindedly poking the treated area can shift the filler before it has time to settle into place. It also raises your risk of introducing bacteria to the injection sites, which are essentially tiny open wounds.
Icing the area in short intervals (10 to 15 minutes on, then off) helps manage swelling without putting too much sustained pressure on the filler. Use a clean cloth between the ice pack and your skin rather than pressing ice directly against the injection sites. Some puffiness is completely expected, especially with lip filler or under-eye treatments, and doesn’t mean anything went wrong.
Skip alcohol for at least 24 to 48 hours after treatment. Alcohol dilates blood vessels and thins your blood slightly, which worsens bruising. For the same reason, avoid aspirin, ibuprofen, naproxen, fish oil, vitamin E, and supplements like ginkgo biloba during this window. If you need pain relief, acetaminophen (Tylenol) is generally the safer choice since it doesn’t affect blood clotting.
Exercise and Heat Exposure
Most providers recommend avoiding strenuous exercise for 24 to 48 hours after filler. Intense physical activity raises your heart rate and blood pressure, which pushes more blood flow to your face and can increase swelling and bruising. Light walking is fine, but hold off on running, weight lifting, hot yoga, and anything that gets you significantly flushed.
Heat is a separate concern. Saunas, steam rooms, tanning beds, and prolonged sun exposure should be avoided for at least 48 hours. Heat expands blood vessels in the skin, amplifying swelling and potentially affecting how your results develop. Even a very hot shower can contribute, so lukewarm water is a better bet for the first couple of days.
How to Sleep After Filler
Sleep on your back with your head slightly elevated for at least the first two nights, and ideally for a full week. Elevation helps fluid drain away from your face, reducing morning puffiness. Lying face-down puts direct pressure on the filler and can cause it to shift or settle unevenly, so stomach sleeping is the main position to avoid. Side sleeping isn’t ideal either during the first few days, particularly if you had filler in your cheeks or jawline.
If you’re not a natural back sleeper, surrounding yourself with pillows on both sides can help keep you from rolling over during the night. An extra pillow or a wedge pillow under your head provides enough elevation without being uncomfortable.
Skincare After Filler
Keep your skincare routine gentle for the first 48 hours. That means pausing any products with retinol, glycolic acid, salicylic acid, or other strong active ingredients. These can irritate the skin around injection sites, increase redness, and slow healing. Stick to a mild cleanser and a basic moisturizer during this period.
After 48 hours, most people can gradually reintroduce their normal products. If your provider gave you specific instructions that differ from this general timeline, follow those instead, since certain treatment areas or filler types may need a longer break from actives.
When Filler Fully Settles
Don’t judge your results right away. Fillers typically take one to four weeks to fully settle, and the process happens in stages. During the first week, swelling is at its peak, and many people feel like their filler looks “too much.” This is almost always temporary. Bruising and puffiness gradually diminish over the first two weeks.
What’s actually happening beneath the skin during this time is that hyaluronic acid filler absorbs water and integrates into the surrounding tissue. This means your results at day three will look noticeably different from your results at week three. The filler softens, sits more naturally, and blends with your facial contours over the course of several weeks. The final, settled result often looks significantly more subtle than what you see in the mirror the day after treatment.
Signs Something Is Wrong
Mild swelling, tenderness, bruising, and slight asymmetry are all normal in the first few days. What isn’t normal is a specific set of symptoms that can signal a vascular occlusion, which occurs when filler accidentally blocks a blood vessel. This is rare, but it requires urgent attention.
Watch for these warning signs:
- Skin blanching: the skin turning white or unusually pale near the injection site, sometimes appearing immediately or within minutes
- A mottled, net-like pattern on the skin (a lace-like discoloration that looks different from a normal bruise)
- Severe or escalating pain that feels disproportionate to what you’d expect from a simple injection, especially if it worsens in the hours after treatment rather than improving
- Dusky or bluish skin in the treated area
If you notice any of these, contact your injector immediately. Vascular occlusion is treatable, but outcomes are significantly better the sooner it’s addressed. Normal bruising, by contrast, looks like a typical bruise (purple, yellow, or greenish), is mildly tender rather than severely painful, and gradually improves each day.
Quick Reference: What to Avoid and For How Long
- Touching or massaging the area: avoid for at least 24 hours
- Alcohol: avoid for 24 to 48 hours
- Blood-thinning medications and supplements: avoid for 24 to 48 hours after (and ideally 7 to 10 days before)
- Strenuous exercise: avoid for 24 to 48 hours
- Saunas, steam rooms, and intense heat: avoid for at least 48 hours
- Retinol and strong acids: avoid for at least 48 hours
- Sleeping face-down: avoid for at least one week