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.

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.

Thank you for your question.  Here are a few protocols to help reduce risk of bruising after facelift surgery:Sleep with your head up as much as possible. This can be done be propping yourself up in bed with 2-3 pillows. This will allow any residual fluid to drain away and will ease the feeling of facial Fullness.Drink plenty of fluids and eat well the evening of your procedure You may require some mild painkillers in the first few days post Concept Facelift, We would recommend a combination of Ibuprofen and Paracetamol- providing you are not allergic to either of these medications.After care in the following days and weeks post procedure You will already have received your follow up Consultation appointment for approximately 5-7 days post procedure. However it is important to continue to follow the subsequent “Do’s and Don’ts”.Do use a cool pack on the incisions as this will help reduce any residual fullness.Do continue with painkillers if required, as around 5% of patients will have some ear pain which will settle within a week or two. Do resume normal activities however avoid vigorous exercise or heavy lifting for 2 weeks post procedureAll The Best 

Some swelling and bruising is to be expected. Bruising is treated with Arnica, an herb that will be
provided by our office. Swelling and bruising is maximal at 48 hours post-surgery and gradually subsides
over the following 10-14 days. When you rest or sleep, keep your head elevated 2-3 pillows and avoid turning of your side. If you
overexert yourself, bleeding or prolonged swelling may result. Keep your emotions under control. It is not unusual to feel a bit depressed for a few days after
surgery. This quickly passes as you begin to look and feel better. Anger, crying or other emotional
outbursts will only add to the swelling or increase the likelihood of bleeding. Ice packs should be used within the first 48 hours after surgery to help with swelling. Apply ice for 15-
20 minutes out of each hour while awake. Be sure they are lightweight. Never apply ice directly to the
skin. Dipping gauze pads into iced water works well.

Swelling and bruising is normal after a facelift and, on average, lasts about 14 days. Of course, that is an average and there are people on either side of that number. There are younger patients who only bruise for 5-7 days and there are older individuals who bruise and swell for 6 weeks but on average, 14 days is what most people get.The amount and duration of the swelling and bruising depends on several factors such as diet before the procedure, medications, herbal supplements, activity after the procedure, age (vessels are more fragile as one ages), the extent of the procedure, other concomitant procedures adding to the bruising, habits such as smoking, and envirnomental factors such as heat, excessive sneezing or coughing, etc. You can help bruising by increasing your intake of pineapple, arnica montana, and papaya extract; all of these have been shown to minimize bruising formation. To improve an existing bruise, consider lympatic massage by your surgeon's office, topical arnica montana, and topical vit K in addition to increasing intake of green leafy vegetables. Hematomas, a collection of blood under the skin, even when cleared still leaves behind a residual amount of blood under the skin and can prolong the bruising period. This has nothing to do with the expertise of the surgeon as hematomas are a common part of facelifts (though each surgeon has a different rate of hematomas and the national average is 3%).  In the end, bruising always goes away, but can be a nuisiance when it doesn't resolve as expected. Good Luck!

There are a number of factors that influence the risk of bruising and haematoma following facelift. These include the type of procedure, a patient's medical history, anticoagulant drugs, smoking and the experience and expertise of the surgeon. Having said all of that, there is one thing a patient can do to minimise the risk and that is to rest with his/her head elevated and not to try and mobilise too early. Patients are often very nervous before this type of surgery and can sometimes feel quite over excited and relieved afterwards, which leads them to be far too active in the first few days. The best advice I can give is for a patient to listen carefully and obey post-operative instructions to the letter. This is the single biggest thing that you can do to improve your chances of a smooth recovery.

Hematoma so following a facelift occurs occasionally and is an inherent risk of the procedure.  Avoiding aspirin and other blood thinners prior to surgery is the most important factor in preventing hematomas.  Even the best surgeons get an occasional hematoma.  High blood pressure and over activity after surgery can also increase your risk.

Any excellent surgeon can get a post-op hematoma. That being said, a patient can take arnica montana to reduce his/her chances of getting a hematoma. A drain can also decrease the risk of bruising. Best of luck.