How can I reduce swelling and bruising ?

Question

I have upper and lower eyelid surgery scheduled for Feb. 10th of this year . Are there any methods or supplements to minimize swelling and or bruising post op ?

Mark K. Markarian, MD, MSPH, FACS · Answer

Thank you for your question about bruising and how to reduce it when it comes to a Blepharoplasty (eyelid surgery).  Always good to plan ahead...This is a concern I hear routinely, and especially with facial aesthetic surgery such as Facelifts and Blepharoplasties.Like most surgeries, I truly feel that the number one way to reduce bruising is meticulous surgical technique and intra-op attention to detail with careful hemostasis (bleeding control).  That is your plastic surgeon's responsibility...  As a patient, however, there are a number of other ways for you to play an active role in reducing bruising, a common concern after Blepharoplasty.Here are some...(1) Apply iced compresses around your eyes for about 48 to 72 hours.(2) Maintain head elevation -- sleep on two pillows, and limit how much you bend over to pick things up -- try to bend at the knees instead of bending over at the waist, to reduce the "rush of blood" to your head, etc.(3) Reduce the risk of bleeding by not taking any "blood-thinning" medications, such as aspirin, NSAIDs, certain supplements such as fish oil, Garlic, Ginkgo, Ginseng, Vitamin E, and certain other herbal medications. (4) Do not drink any alcohol during your immediate post-operative course.(5) Limit strenuous activity for 2-3 weeks -- this will prevent your blood pressure from "spiking" during workouts and thus reduce bleeding (and subsequent bruising).  (6) Maintain good control of your blood pressure -- if you take medications for hypertension (high blood pressure) be sure to take the correct doses around your surgery times, both pre- and post-op.  Also, limit your salt intake to avoid unnecessary elevations in your blood pressure.  (Every little bit helps.)(7) Arnica and/or Bromelain is advocated by some -- it is controversial, but does help some patients.I also routinely offer laser therapy to reduce post-operative bruising. This is a unique option that I offer patients post-operatively for all surgeries I perform.These are all options that you may try.Please talk to your plastic surgeon about any other suggestions.Good luck. Dr Markarian

Elizabeth Whitaker, MD, FACS · Answer

Thank you for a great question and for sharing your concerns.  Arnica Montana and bromolain may reduce bruising.  Icing after the procedure will help reduce swelling.  If you are on any blood thinning agents, pain relievers, or supplements consult your surgeon about discontinuing.  I would ask your surgeon for their pre and postoperative recommendations.  I hope you find this helpful. Best wishes!Consult with a Board Certified Fellowship Trained Facial Plastic Surgery Specialist."This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Jeffrey M. Darrow, MD · Answer

The tried and true methods for best recovery after eyelid surgery are:  Before surgery, stop all meds which could increase bleeding such as NSAIDS, Asprin, Warfarin, Coumadin etc,  stop all herbal or other supplements, stop all medications unless medically necessary.  During surgery have meticulous surgeon.  After surgery do cool moist compresses to your eyes, avoid any activity which would make your face turn red or elevate your heart rate or blood pressure, and avoid salty foods.  Good luck.

Stephen H. Fink, DO, FAOCO · Answer

Avoiding medications that affect blood clotting in the 2 weeks before surgery is most important. This includes products containing aspirin or  NSAIDS,  fish oil, Vitamin E and many other supplements. Keeping your head elevated,  icing the area  after surgery for the first 48 hours and avoiding strenuous activity during the week after surgery is also helpful. Supplements like Arnica  Montana  and Bromelin have anecdotal benefit but are controversial. Many of my patients use them without any apparent detriment. It may also be helpful to avoid salty foods and alcohol and keep you blood pressure under control. I hope you find this helpful.

Ahmad N. Saad, MD, FACS · Answer

It is great you are planning in advance!It is extremely helpful to stop blood thinners, anti-inflammatory drugs and supplements such as fish-oil, garlic etc... ahead of your surgery.What also might help reduce bruising is Arnica Montana supplements, I usually start my patients on Arnica 2-3 days prior to surgery.In terms of swelling, keeping you head elevated after surgery and applying ice packs can help.Good luck!

Adam Scheiner, MD · Answer

Dear Patient from Boston,The surgery process and healing will result in possible bruising and swelling.By stopping use of blood thinners before surgery such as Aspirin, Fish Oil, Garlic, Ginseing, Vita-E etc., you can reduce the amount of bruising that may occur.Also using cool packs for the first 48 hours on the wounds can shrink the vessels in this healing area and reduce swelling and bruising.Best to discuss this with your surgeon.I hope this was helpful.

Frederick G. Weniger, MD, FACS, MBA · Answer

Thank you for your question.  The first thing you can do before your surgery to help decrease the risk of bruising is to avoid any blood thinning medication 2 week before.  That includes prescription and over the counter medication.  After your surgery using ice packs over the eyes for the first 3 days will help the swelling and bruising. Sleeping with your head elavated will help decrease the swelling as well.  Check with your Board Certified Plastic Surgeon if they have any other protocols.  Best Wishes.

William Portuese, MD · Answer

There are many factors and variables that do into how much swelling and bruising patients get after cosmetic eyelid surgery. The factors that patient's can control include avoiding aspirin, blood thinners, vitamin E, and herbal supplements. Also important  not do any heavy lifting in the first week after the surgery.  It is best to check with your operative  surgeon for their  postoperative instructions, since they will be performing your surgery

Steven Wallach, MD · Answer

I think that the best thing to avoid are Aspirin and anti-inflammatory medications.  Other products that purport to reduce swelling and bruising have not been shown to have any efficacy.

Stuart H. Bentkover, MD (retired) · Answer

I am sure your surgeon has preferred techniques for this.  We recommend drinking pineapple juice starting a week before surgery.  It is high in bromelain. You can also get bromelain at health food stores. Iced compresses are very important for 48 hours.

How can I reduce swelling and bruising ?

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