How to Avoid Bruising After Facelift?

Some bruising after a facelift is to some extent inevitable. However the extent of bruising can be minimized, sometimes dramatically. Many "small things" actually add up to a significant difference in the postoperative course.
Aftercare
Every facelift patient in our practice goes to a licensed aftercare facility. The registered nurses at the aftercare make sure the blood pressure does not get too high, a primary cause of bleeding after surgery. In addition to increasing patient comfort and well being, the RN at the aftercare has specific medicines to reduce anxiety, control blood pressure, control postoperative pain
Meticulous, speedy surgery
When surgery is meticulously performed by a very experienced facelift expert, the bleeding is minimal. If surgery can be performed before the local anesthetic wears off, bruising is minimized. It is pleasantly surprising how many patients who considered themselves "bruisers" actually can have an uneventful recovery. The timing and skill of developing an expert technique takes many years and thousands of surgical cases. A seasoned surgical team is also vital to perform dressings in a standardized, consistent, safe, protective fashion.
Board certified doctor anesthesiologists
Having an anesthesiologist with hospital credentials who has specialized in cosmetic surgery is important, in my opinion. They have specialized skills to avoid nausea, high blood pressure, risks during surgery. It does make a difference.
No drains.
We no longer routinely use drains with facelift surgery. The amount of bruising has been greatly reduced with this technique. Remember if there is a drain between the skin and the deep tissues, the tissues cannot stick together in all the locations where the drain is. When the drain is removed, it can further separate the layers as it comes out. The tissue thromboplastin, natural clotting mechanisms cannot stick the skin down because the layers are actually separated by a plastic drain. Of course if the patient has oozing in surgery, a drain may be necessary, but the chance of this is low in our practice.
Preoperative preparation
Every facelift patient receives a stress test before surgery and a thorough workup from their doctor. The doctor is asked to optimize the patient's health and blood pressure well in advance of the surgery. The patient doesn't take medicines that promote bleeding.
Summary
These factors above may all seem trivial, but they are not. If any single step above is missed, the patient will be at higher risk for a complication, including excessive bruising and all the sequelae of that down the road (firmness under the skin, unevenness of results). There is a world of difference between on one hand a medically prepared patient having a procedure in expert hands, recovering in an aftercare facility, and on the other a sloppily prepared patient with borderline hypertension who goes right home after their surgery with a novice or untrained surgeon, nauseated from a clumsy anesthetic.

Thank you for your question. As with any surgical procedure, bruising and swelling is a risk that will occur. Your surgeon will instruct you on how to prepare for your surgery to keep the bruising as minimal as possible. I would advise you to schedule a consultation with a board certified plastic surgeon for a detailed examination to discuss all possible treatment options and what your expectations are.

You will obtain the most optimal results with an expert plastic surgeon who disturbs as little tissue as possible, which in turn creates as little bruising as possible. With my facelift surgeries, I prefer to proceed slowly and cauterize carefully and patiently, because bruising is simply blood that has accumulated under the skin.  Cauterizing prevents this from happening. I have found a correlation between patients who take arnica (a homeopathic pill) and who have very little bruising and swelling.  Patients are also provided with an extensive list of medications to avoid which thin your blood, such as aspirin, Advil, vitamin E etc. to decrease bleeding/bruising. In addition, our practice has an on-site lymphatic massage specialist who treats our patients post procedure, which helps decrease bruising and swelling and overall improves the healing process.  

Bruising is to be expected with any facelift procedure. Hematomas are not common, but do occur, and in some cases, cannot be avoided despite many different preventative measures. Hematomas are a collection of blood under the skin that in some cases will require removal in order to speed recovery, prevent infection, or preserve blood supply to the skin.
The surgeon's technique does play a role, but there are many other patient factors that also contribute to hematoma risk, and hematomas occur to even very skilled and experienced facelift surgeons. Avoiding medications that potentially cause bleeding is one factor. Most doctors will provide you with a list of medications and supplements to avoid in the preoperative period, as well as a list of instructions regarding activity restrictions and care in the postoperative period. The good news is that hematomas are relatively uncommon and can usually be treated quickly and easily without any long term effects.
All the best,

I suggest to my patients beginning supplements such as  bromelain or arnica a week or two before their procedure(s). However, its best to consult with your board-certified Plastic Surgeon beforehand. She or he will make suggestions according to your procedure and medical records in addition to discussing your pre-op preparations. Also, such may be provided for you with your pre-op material and prescriptions in time for your recovery period. You will learn more about preparing at your pre-op appointment. 

Bruising is a normal part of plastic surgery, especially procedures of the head and neck, as this part of the body is quite vascular. Choosing a board-certified plastic surgeon who boasts extensive positive results with facelift surgery is the best thing you can do to minimize bruising. The more efficient the surgery, the less bruising will emerge. Additionally, following your surgeon's instructions for caring for yourself both before and after surgery can go a long way toward preventing bruising. It's important to discontinue to the use of aspirin, alcohol, and other substances that contribute to bleeding. After surgery, avoiding strenuous activities for several weeks and keeping your head upright as much as possible can help, too.