1) Acute Phase — First 12–24 hours

• Short cold compress cycles (5–10 min) — avoid direct ice and pressure.
• Avoid touching, massaging, or applying pressure to the treated area.
• No strenuous exercise, sauna, or excessive heat exposure.
• Avoid alcohol and blood-thinning supplements unless advised otherwise.
• Sleep with head elevated (~30°) to reduce edema.
• Maintain adequate hydration.

2) 48–72 hours — Managing swelling and bruising

• Antihistamines can be considered if needed and appropriate.
• Topical arnica or bromelain products may reduce bruising.
• Avoid lasers or aggressive RF procedures until area stabilizes.
• Light cosmetic cover-up may be used with caution.

3) Common Complications & Clinical Management

Hematoma

Signs: focal bruising, localized pain, firmness. Management: cold compress first 24h, then warm compress; arnica/bromelain; sonographic assessment if extensive; consider drainage only under clinical indication.

Prolonged Edema

Signs: swelling beyond 72 hours. Management: evaluate injection technique and filler type, consider antihistamines, targeted massage; short course corticosteroid may be considered by the treating physician if inflammatory cause suspected.

Nodules

Inflammatory (warm, painful) vs non-inflammatory (painless). Management: warm compress, controlled massage; for inflammatory nodules: antibiotics and/or steroids; refractory cases — hyaluronidase (if HA filler).

4) Ischemia — Emergency Protocol

Warning: Vascular occlusion is a medical emergency. Rapid recognition and treatment improve tissue salvage.

Early signs:

• Severe progressive pain
• Pallor or livedoid/purple discoloration
• Cold skin and delayed capillary refill

Immediate actions (Golden Time < 4 hours):

1. Rapid clinical assessment and documentation;
2. Urgent hyaluronidase injections along the filler track (for HA fillers) — follow clinic protocol for dosing and distribution;
3. Controlled massage and warm compresses;
4. Topical nitroglycerin may be used cautiously where indicated;
5. Consider aspirin 300–325 mg if not contraindicated to support microcirculation;
6. If no rapid improvement → refer to specialized vascular/plastic team or emergency services.

Note: Hyaluronidase dosing and technique must follow manufacturer’s guidance and clinician training.

5) Stabilization Phase — 1 week to 1 month

• Avoid excessive heat, aggressive massage, and invasive procedures (deep peels, lasers) until full stabilization;
• Use light emollients and maintain hydration;
• Schedule follow-ups: 48–72 hours and ~2 weeks post-procedure.

My Cyprus, [12/6/2025 3:34 PM]

6) When to Seek Immediate Care

• Severe or worsening pain
• Skin color changes (pallor, mottling, purple)
• Fever or systemic symptoms
• Unilateral significant swelling or a painful mass
• Any visual disturbance (emergency)

Specialist Support & Emergency Access

For urgent assessment, hyaluronidase administration, or complication management, contact Dr. Seyed Ahmad Mohammadi and the MDAcademyAI Cyprus clinical team.

Contact / Emergency referral: place your contact form or WhatsApp link here.