Bruising is a natural part of having invasive procedures. In fact, bruising should be expected after many procedures and does not mean anything bad has happened. Bruising commonly happens after surgical procedures like rhinoplasty (nose job), face-lift, and blepharoplasty (eyelid surgery). Even minimally invasive procedures with injectables like Botox and dermal fillers can cause bruising. While most bruises resolve within a week or two these can be troubling for patients who want to get back to life quickly with minimal downtime.
Why all the crazy colors?
A bruise, or ‘ecchymosis’, is the appearance of blood under the skin. It doesn’t take much blood to cause the appearance of a bruise. Even microscopic vessels can cause a visible bruise. Usually these start out dark blue or purple. As the blood is broken down by enzymes in the body, the color changes to lighter greens and yellows. The blood is broken down further and further by enzymes until it is ultimately resorbed by the body without any lasting effect. So, rest assured that the color change means the bruise is clearing!
What should you avoid to reduce bruising?
Always consult your doctor before starting or stopping medications. To prevent bruising in the first place, avoid medications that can thin the blood, particularly before an upcoming procedure. This includes over the counter medications like aspirin, ibuprophen, or naproxen. Some combination medications like Excedrin contain aspirin in them. Be sure to read labels for active ingredients! Supplements have many health benefits. Supplements can also have unintended side-effects or interact with other medications. Many commonly consumed supplements can also increase the risk of bleeding like high dose fish oils, Gingko biloba, garlic, and vitamin E. Your doctor may recommend you stay away from these prior to a procedure.
Is there anything you can take to reduce bruising?
Foods high in bromelain have been shown to dramatically reduce bruising. Bromelain is an enzyme that helps break down proteins needed to clear up bruising faster. Foods high in bromelain include pineapple (the juice and the stem), papaya, kiwifruit, and figs. Pineapple is among the best source of bromelain. Bromelain supplements are available however some studies have suggested that ingesting the fresh fruit of a pineapple, particularly the stem, contains more than 10x the active enzyme than available supplements. When should you start? If you want the best effect, start up some bromelain rich foods in the few days leading up to your procedure and continue for up to a week after depending on the procedure. This can help clear up bruises even after injuries like an unexpected fall.
Arnica montana is an herbal supplement that has also shown some ability to reduce bruising and swelling. This is commonly recommended for patient undergoing rhinoplasty and/or face-lift. This can be used orally or topically and is sold over the counter. Like other supplements, there could be side-effects or drug interactions.
Remember that bruising is usually a normal part of the healing process and will clear up. If you have concerns, always consult your provider. A healthy diet, good hydration and positive attitude during the healing process are key. A little pineapple is the cherry on top!
Roxana Moayer, MD is a facial plastic and microvascular reconstructive surgeon. Her clinical specialties include treatment of facial nerve disorders and synkinesis, facelift and neck lift, rhinoplasty, blepharoplasty, brow lift, cosmetic facial skin treatments including microneedling and PRP, facial reconstruction (following trauma and cancer), hair restoration, facial feminization, and otoplasty. She is dedicated to helping patients look like the best version of themselves, driven by a strong belief that such work is inextricably linked to their self-confidence and overall health. Her attention to detail and aesthetic eye, paired with advanced training in cutting-edge techniques, allows her to deliver reliable, safe and natural-looking results.
After completing her medical doctorate at the Keck School of Medicine of USC, Dr. Moayer continued to the University of California, Los Angeles to complete her internship and residency. From there, she moved to Philadelphia for an additional year of training at one of the highest volume, AAFPRS-accredited fellowship training programs in the country, Jefferson Facial Plastics. She is currently an assistant professor on faculty at the Keck School of Medicine in the Department of Otolaryngology Head & Neck Surgery.
Dr. Moayer is also involved in the Face-To-Face program, an organization affiliated with The Break the Silence Foundation against domestic violence that provides plastic surgery treatment for survivors of domestic abuse.