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Bruise Prevention 101: Insider Skincare Tips

 
     So you have a cosmetic procedure booked and your plan is to look instantaneously fabulous…?
     But what if you bruise?  Have you talked to your provider about downtime?
 
     In case you aren’t already familiar with the term, there are basically two types of downtime to consider.  The first, being Clinical Downtime. When we refer to clinical downtime, we are considering the amount of time you will have to refrain from or modify activities of daily living.  In the non-invasive cosmetic world, this is relatively short to non-existent when compared to the surgical world.  The other kind of downtime we refer to more commonly is Social Downtime. Social downtime depends on the procedure as well as the patient’s own level of personal comfort.  When we refer to social downtime, we are describing just how long you will likely want to refrain from social outings, lest others know that you had a procedure performed which you would rather keep private, or because you may not want to draw attention to your appearance in public.
 
     To be honest, in this day and age of masks and virtual gatherings, most individuals are alot more relaxed about social downtime.  It’s actually kind of liberating.
 
     Nonetheless, many of us prefer to experience limited social downtime based on principle, alone.  When we have a surgical procedure performed, we understand we are going to bruise and swell; however, when we have a non-invasive cosmetic procedure performed, we are seemingly a little less accepting of a bruise.The fact of the matter is, you’re having a procedure performed.  There’s a chance you will have some transient purpura or edema (that’s just another name for bruising and swelling, we just thought you might want to hear something different, for a change).
 
     But if downtime is only limited to extravasation (synonyms, again), there are a few things you can do – before AND after a procedure to minimize your “downtime”.
 
     As always, have this conversation with your personal provider before the procedure in case they have any other considerations.  Recommendations will vary depending on the kind of procedure you’re having performed as well as your own medical history and provider preferences.
 

Bruise Prevention 101

 
Q: What makes a person more likely to bruise?
 
A: A number of factors lend themselves to bruise susceptibility, primarily, hematologic status which can be effected genetic conditions or exogenous blood thinners.  Other factors include strength of supportive structures like collagen and elastin in the skin and blood vessels which can be further effected by nutritional deficiencies or DNA damage (caused by the natural aging process or sun exposure), etc.
 
* Want to learn how to strengthen the supportive structures of the skin? Learn more about what you can do to enhance the longevity of your collagen and elastin, here.
 
Q:  Should I discontinue blood thinners prior to a cosmetic procedure?
 
A:  Typically, it’s not the standard to discontinue a therapeutic blood thinner for cosmetic procedures – To put this in perspective, we routinely perform cutaneous surgeries for skin cancer as well as other skin conditions. We DO NOT  ask patients to discontinue their blood thinners prior to surgery because the risk of having a stroke or heart attack weigh much more heavily than blood loss which we are comfortable controlling intraoperatively.
 
Q:  I’m not on prescriptive blood thinners but I do take supplements.  Can these thin my blood and make me more likely to bruise?
 
A:  Yes, it is well known that many herbs, vitamins and cofactors can have blood thinning effects among other functions. Here is a list of the more commonly consumed “blood thinners” you may not realize have this effect.
    • Omega3s– these can be found in cold water fish, krill, cod liver oil, borage oil and flax seeds.
    • Garlic – an herb commonly used in cooking as well as complementary medicine, to lower cholesterol and blood pressure as well as balance gut bacteria and support the immune system.
    • Vitamin E – a fat soluble vitamin and antioxidant which supports immune function and cell health.
    • Turmeric – a potent anti-inflammatory antioxidant containing root used traditionally in Ayurveda as well as modern day complementary medicine.
    • Willow bark – contains salicin which actively reduces joint pain and inflammation without the negative gastric effects.
    • Ginseng – a root which is used to benefit sexual libido, energy levels, and brain performance.
    • Primrose Oil – commonly used to reduce symptoms of menopause, PMS and treat skin conditions.
    • Red Clover – often used to reduce symptoms of menopause due to it’s estrogenic effects.
    • Fenugreek – an anti-inflammatory and galactogogue (stimulates milk production).
    • Ginger – a flavorful root used in cooking as well as nausea and indigestion suppression as well as many other medicinal applications.
    • Ginkgo Biloba – a popular vasodilator used to enhance memory and brain function.
    • Cinnamon – an anti-inflammatory spice which has been studied to lower blood sugar levels in Type 2 Diabetes Mellitus as well as soothe digestive discomfort.
    • Grape Seed Extract -studied as an aid to poor circulation and a potential mild alleviator of high cholesterol.
    • Cayenne Peppers – commonly used for spice and flavor as well as weight loss (via metabolism boosting properties) and alleviating pain.
     Remember, these herbs and compounds are healthful and can (and should) be found in a well balanced diet in moderation.If you’re truly concerned about bruising and your doctor hasn’t advised against it, minimize your intake of these compounds – at most, avoiding supplementation to your regular well rounded diet for about 5 days, which is how long it can take for certain blood thinners (whether pharmacological or naturally occurring) to lose their therapeutic effect on the body.       As far as what else you can do BEFORE injectables or surgery to minimize swelling and bruising – The MOST important thing to avoid is alcohol. Alcohol thins your blood by interfering with the clotting process both directly and indirectly.  Firstly, it interferes with blood cell production in the bone marrow, reducing the number of platelets in the blood. Additionally, alcohol then makes those existing platelets less “sticky”, increasing the time it takes for your blood to clot.

Post Procedure 202

 
     Congratulations, you had your cosmetic procedure and it was a great experience.  You’re just about ready for your debut.  But before you get ahead of yourself, there’s a couple rules seasoned pupils have learned through the process.
 
Rule #1: Keep Arnica Montana Handy
 
     Many patients who are very familiar with cosmetic maintenance grow this medicinal flower in their backyard (just kidding – though if you live in the Pacific NW, it’s not a half bad idea).  Arnica Montana has been used topically since the 16th century by doctors in the European Alps as a remedy for sprains, strains, bruising and inflammation.  This plant is so therapeutically effective, we carry it in our office.
 
Rule #2:  Keep Your Chin Up
 
     No, really – keep your chin up.  Keep your entire head up, for that matter.  After a cosmetic procedure, you should keep your head above your heart for the remainder of the day.  The goal is to keep your blood pressure down because that can give any swelling a nice “pump” which we don’t want… Furthermore, when you go to bed the next couple nights, prop a couple pillows under your head (IF you’re able to comfortably sleep in this position). This minimizes the blood pressure in the face while you face, reducing discomfort or swelling.Yet, still… no matter what you do… you’re still going to get a bruise…

How To Treat An Unwanted Bruise:  The Cliff Notes

 
     Depending on where your provider injected, you may end up with bruising in swelling in places you may not have anticipated.  Often times, the bruise stays local to the injection site; however, sometimes, blood travels beneath the skin with gravity along the path of least resistance.  If you had work performed around your forehead or eye area, you may wake up the following day to a black eye, and in some cases, swollen eye lids or bags under the eyes. When work is performed around the mouth, it is not uncommon to bruise along the chin and jawline, or even find blood settling beneath the skin ( = a bruise) along your neck or clavicle. This concerns most individuals the first time it happens, but don’t worry, it’s typically normal.  As always, inform your provider if you feel something unusual may be occurring after a procedure.
 
IF the unavoidable bruise does occur – you can start warm compresses about 48 hours after your procedure to help “break up the blood”.  Cold compresses are helpful during and right after a procedure because cold causes vasoconstriction, or squeezing/shrinking of the blood vessels. This decreases the diameter of the blood vessels, making a smaller passage for them to flow through as they bump along and stick to eachother, encouraging clot formation and controlling bleeding and leaking.
 
This is a good time to take those Arnica Montana supplements as directed, around the clock, in addition to eating pineapple or papaya.  The enzymes bromelian, and papain, respectively, work like meat tenderizers: helping to break down that blood under the skin to be more easily resorbed.

THE WRAP UP

 
While there are some things you can do to lessen your chances of getting a bruise, if you are getting a cosmetic procedure done, bruising and swelling are always fair game.Keep this in mind when you schedule your cosmetic appointment. Don’t get Botox a day or two before your wedding or filler the day before your social media influencer photography session. Give yourself a good week before an event, or even more – for these rescue treatments to work. Regardless, this time frame is often what can be expected for your enhancement to naturally settle, even without bruising.
 
Always remember, if you want to get the most out of a treatment, do your research, ask your questions, come prepared, and give yourself enough time to heal before showing off your amazing results.  When you understand the hows and whys of a treatment, you can own your health and work with your provider to ensure you have best outcome possible.

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