How to Decrease Bruising after Plastic Surgery

How to reduce bruising after plastic surgery 

 

This post is about how to reduce bruising, but it’s important to read a previous post about how to decrease swelling after plastic surgery before reading on:

https://tavmd.com/2012/11/13/how-to-decrease-swelling-after-cosmetic-plastic-surgery/

Causes of bruising after cosmetic plastic surgery

Let’s see how bruises form. When blood vessels are injured in surgery through cutting, they will bleed into the tissues around them. This bleeding shows up as bruising (in a red, blue and black color) under the skin. Any action or medication that interferes with or delays the normal healing process and stops blood clotting will cause bruising. With time, leaked red blood cells start to break down into bilirubin and iron components, creating a yellow color as the bruises heal. White blood cells then come into the injured skin area and start to remove the remnants of red blood cells.

Some areas of the body are not covered with skin, such as the eyes. When bruising occurs around the eyes, such as after a cosmetic eyelid surgery, blood actually shows red in the white part of the eye!

Here are some other posts about swelling and bruising and the use of ice and heat after plastic surgery:

https://tavmd.com/2011/08/30/swelling-after-liposuction/

https://tavmd.com/2011/02/05/should-i-apply-heat-or-cold-after-plastic-surgery/

 

How to stop bruising after plastic surgery

Stopping bruising involves not only the removal of blood that has seeped into tissues, but also mechanisms to heal vessels and encourage clotting along injured vessel walls so that no more blood seeps out.

  • Elevation of injured area

Decreasing blood flow will decrease swelling and the amount of blood that seeps into the skin through injured vessels.

  • Ice

Cold contracts blood vessels, resulting in fewer cells going out into the tissues. Likewise, avoiding heat (heating pads or warm towels) will be beneficial in the initial 72 hours after surgery because it increases flow and bleeding before the blood vessels have had time to heal.

  • Avoidance of NSAIDs

NSAIDs (see above) decrease blood clotting. Specifically, they decrease the production of prostaglandins, which are essential for forming a clot. No clot and you keep on bleeding. Swelling might be decreased, but you keep on bleeding!

 

  • Foods to increase vitamin K

Food high in vitamin K levels, such as green leafy veggies (or even vitamin K pills), can also help clotting.

 

  • Pressure on injured area

Applying pressure to bleeding areas will help clotting, decrease swelling and decrease the amount of blood that escapes. Once bleeding has stopped, pressure does not do any more good other than to decrease swelling.

 

  • Application of heat after 48 hours

The initial application of ice to an injury site will decrease bruising. After 48 to 72 hours, though, once the blood vessel has clotted, applying gentle heat with something like a moist warm towel will encourage blood flow through normal vessels, which aids in the removal of remnants of dead red blood cells in tissues. Some of my Far Eastern patients roll freshly hard boiled eggs (shell on) over the areas of bruising for heat and massage at the same time!

Of course, you should call your plastic surgeon immediately if you have an area of bruising under the skin that is getting large. This may be a hematoma, a large collection of blood under the skin that may need to be surgically removed.

 

Morad Tavallali, M.D., FACS