Table 2.

Strategies for the Prevention and Treatment of Short-Term Swelling Following Injection of HA Filler in the Infraorbital Area

Prevention of short-term swelling
Use the correct product (HA filler with low propensity for swelling)
Use lower volumes (ideally ≤0.5 cc per side per session)
Use antihistamines (for patients with a history of reactivity to injury, allergens, or history of hypersensitive foreign body response)
Sleep upright with several pillows
Decrease salt intake and aerobic activity (lower blood pressure)
Mix in triamcinolone (1 mg/mL of filler)
Silicate cream overnight after treatment for compression
Treatment of short-term swelling
Watchful waiting, firm massage (down and out with a lubricating cream or topical steroid) by injector, and reassurance
Topical cortisone cream to massage at home several times per day
Silicate cream during the day and overnight for compression
Diuretics or antihistamines(only effective in select cases, if allergic component is suspected)
Local triamcinolone injection (no more than 0.1 cc of 2.5 mg/cc) subdermal (avoid intradermal)
Oral steroids (Medrol dose pack or 10 to 40 mg prednisone ×5 days depending on patient weight and severity of swelling).

HA, hyaluronic acid.