Everything You Need To Know About Facelift Bruising

Written by Cameron Craven, MD, FACS, Board Certified Plastic Surgeon on August 13, 2021 No Comments

facelift woman

Bruising and swelling commonly occur after facelift surgery. While temporary, bruising after facelift surgery can be inconvenient and embarrassing. While there’s no way to predict the extent to which you’ll bruise, there are ways to reduce the risk and duration of skin discoloration after the procedure. Here’s everything you need to know about bruising and facelift surgery.

Why Bruising Occurs After Surgery

Bruising is just one way the body responds to the trauma of injury. Bruising after surgery typically occurs near incision sites or where structural changes have occurred. After a facelift, it’s common to see bruises around the eyelids, mid-face around the cheeks, or around the lower face and neck.

A bruise develops when capillaries are injured, releasing a small amount of blood that remains trapped beneath the skin. Bruises can range in color from yellow, to green, purple, blue or black. As bruises heal, they typically transform from a darker to lighter color.

Swelling is the result of fluid accumulation and a natural part of the body’s inflammatory response to surgical procedures. The influx of fluid to an area helps speed the healing process.

Bruising is also a normal, natural part of facelift recovery and doesn’t necessarily signify anything is wrong. However, if bruises get darker, more swollen or become more painful over time it may be best to notify your surgeon.

When Bruising Becomes Abnormal

Excruciating pain, swelling or bruising that increases over time may be a signal that you have a hematoma. This occurs when blood collects underneath skin tissues, creating pressure.

Severe pain that’s worse on one side of the face versus the other is also a reason to seek medical help. Bruises, however, need not be symmetrical. For example, it’s possible to have a bruise around one cheek and not the other, even though a facelift procedure affects both cheeks the same.

Will I Bruise After My Facelift? 

Post-surgery bruising is more pronounced in some patients than others. It’s difficult to predict if bruising will happen to you. Bruising is more likely to occur in older versus younger patients. You might also be at greater risk for bruising if you tend to bruise easily after minor bumps or injuries. Finally, the extent of bruising may also depend upon the specific type of facelift technique used.

How Long Does Bruising Last? 

Swelling will be most prevalent a few days after your facelift and should subside soon afterwards. Most patients find swelling reduces within the first few weeks after surgery.

Bruising is more difficult to predict. Dark bruises typically change color and begin to fade after two weeks. Bruising should no longer be noticeable, especially when covered with light makeup, after one month.

Post Facelift Discoloration

In addition to bruising, other common types of discoloration may occur after your facelift.

Post-Inflammatory Hyperpigmentation

Post-Inflammatory Hyperpigmentation, or PIH, occurs when skin darkens along the incision site. The most common reason for hyperpigmented scars is UV exposure. PIH is preventable by following your doctor’s post-operative care instructions and avoiding sun exposure.

Hemosiderin Staining

Hemosiderin staining is the yellowish or shadowy tint that lasts after the initial bruise fades. This is most common in those who have experienced severe bruising. The body’s immune system will eventually break down the discoloration, a process that may take several months.  Sometimes laser treatment can accelerate the resolution of hemosiderin staining.

Spider Veins

Those with light or thin skin may notice an increase in spider veins after facelift surgery. This commonly resolves itself within 6 months. If your spider veins persist, laser treatment is an option.

How To Minimize Bruising After Your Facelift

To minimize risk of bruising and swelling after your facelift surgery, consider the following:

  • Stop taking blood thinners 10 days before surgery (if you are permitted by you PCP or cardiologist to stop them)
  • Closely follow your surgeon’s post-operative care instructions
  • Get plenty of rest the first two weeks after your procedure
  • Keep your head elevated above your heart for at least the 1st week post-op
  • Introduce light walking as soon as possible to keep blood flowing (usually light exercise is permitted 2 weeks after surgery)
  • Stay hydrated and eat a healthy, low-salt diet while recovering
  • Laser treatments are available that may significantly reduce the appearance of bruising and the duration of discoloration in patients with severe enough bruising, but this is not typically necessary

Covering Bruises with Makeup

Most doctors recommend scheduling two weeks of at-home recovery time to allow bruising and swelling to subside before you’re active again. When you’re ready to get out and about, covering your bruises with makeup can reduce embarrassment and strengthen self-confidence.

  • To avoid infection, get cleared by your doctor before applying makeup to your face
  • Work with a professional cosmetologist who can recommend tones that work best with your skin
  • Choose thick formula foundations for better coverage and adherence to scar tissue
  • Select hypoallergenic, non-comedogenic, fragrance-free products to avoid irritation
  • Stop the use of makeup if you experience redness, itching or any other signs of irritation or allergic reaction

Bruising and swelling after facelift surgery typically lasts no more than 4-6 weeks. As bruising diminishes, it will be easier to cover up with makeup, allowing you to flaunt your more youthful and vibrant face.

Cameron Craven, MD, FACS

Cameron Craven MD, FACS is board certified by the American Board of Plastic Surgery. Dr. Craven specializes in the full spectrum of cosmetic surgery including breast augmentation, liposuction and body contouring, facial rejuvenation, laser surgery, eyelid surgery, and rhinoplasty, as well as reconstructive surgery for skin cancers.

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