Here is the truth about aftercare: most patients are googling their symptoms at 2 a.m. wondering if the lump they feel is normal, the bruise is too dark, or the swelling means something has gone wrong. Almost always, it is fine. Occasionally, it is not. Knowing the difference is the whole point of this article.
What follows is a calm, day-by-day breakdown for the most common injectable treatments. It is not a substitute for your own aftercare instructions or for calling Angela if something feels off. It is the framework that should make the calling, or the not calling, easier.
The first 24 hours
The universal rules in the first 24 hours after any injectable treatment:
- No vigorous exercise. Walking and normal daily activity is fine.
- No saunas, steam rooms, hot tubs, hot yoga, or very hot showers.
- No alcohol. It thins the blood and worsens bruising.
- No blood-thinning medications unless prescribed (skip ibuprofen, aspirin, fish oil if cleared with your doctor).
- No facial massage, no pressing or rubbing the treated area.
- Sleep on your back if you can.
What is normal in this window: small pinprick marks at injection sites, mild redness, a feeling of tenderness or tightness. For lip filler specifically, real swelling that makes your lips look noticeably bigger than the intended result. For Botox, possible mild headache for some people.
Day 2 to 3
This is the peak. If you are going to swell, this is when it shows. Bruising, if any, can darken before it fades (it gets worse-looking before it gets better-looking, which is normal). For lip filler, mornings are typically the worst. You wake up puffy and it eases through the day.
Normal: visible swelling, possible bruising in shades of red, blue, or yellow as it ages, lips that look "too big" if you got filler. Some people feel small bumps under the skin, especially in the lips. Most of these resolve on their own as the product integrates.
Helpful: a cool compress for short intervals (5 to 10 minutes), staying upright as much as possible, keeping water intake steady. Arnica gel or supplements may help bruising.
Day 4 to 7
Things start settling. Swelling drops noticeably. Bruises shift through the rainbow of colour stages and begin fading. Lips look much closer to the intended result. Botox is beginning to take effect if you got it (relaxation typically starts at day 3 to 5 and becomes more obvious through this window).
Normal at this stage: continued mild swelling that can come and go, especially morning vs evening; the occasional small lump that softens as you move and talk; for Botox, gradual relaxation of treated muscles that is more obvious to you than to anyone else yet.
By the end of day 7, most people look like themselves again, just rested or refreshed.
Day 8 to 14
This is when your final result emerges. For filler, the product has integrated with your tissues and the shape you see now is your true outcome. For Botox, full effect is in by day 10 to 14.
If anything is going to need a small adjustment, this is the window to discuss it. A two-week follow-up is the standard checkpoint. If something is asymmetrical, off, or you want to fine-tune, that conversation belongs at the two-week mark, not on day three when you are still swollen.
I will say this clearly: do not judge your results before two weeks. The number of patients who panic at day three and then love their result at day fourteen is, every single year, my entire patient list.
The "should I worry" framework
Here is how I think about the difference between concern and normal.
Almost never an emergency
- Bruising, even big bruises
- Swelling, even dramatic swelling for lip filler
- Mild asymmetry in the first week
- Small palpable lumps in lips that soften over a week
- Mild headache after Botox
- Slight tenderness for several days
Call Angela soon
- Asymmetry that worsens, not improves, after day 3
- Lumps that grow rather than soften
- Persistent pain that is not improving by day 4
- For Botox, drooping eyelid or brow
Real emergency, do not wait
Skin that turns white, dusky, or grey near the injection site. Vision changes of any kind. Sudden severe pain. Breathing trouble or swelling of the throat. Spreading redness with fever. These are not common, but they are time-sensitive when they happen.
For HA filler complications specifically, the reversal enzyme hyaluronidase is available and can be administered in clinic when indicated. Calling early matters because the management of vascular concerns is time-dependent.
If you cannot reach Angela quickly and you have something from the real-emergency list, seek emergency care. Bring a record of what was done and when.
The honest take
Most aftercare is uneventful and the question of whether to call is a question about anxiety more than about emergency. Here is the reframe: you are not bothering anyone by calling. Angela would rather hear from you at day 2 about something that turns out to be normal swelling than at day 5 about something that has been quietly getting worse.
If you remember nothing else from this article, remember that calling early is always the right move. The cost of an unnecessary call is a quick reassuring conversation. The cost of waiting too long can be a real problem.