By Dr. Scott J Turner, Specialist Plastic Surgeon | Published: 21/06/2025
After your facelift surgery, you’ll naturally be excited to see your refreshed, natural-looking results. It’s also completely normal to feel a little anxious about the recovery process. Let’s talk about the most common concern: bruising and swelling.
Think of bruising and swelling as signs that your body is doing its job. They are a completely normal and expected part of the healing process. While we can’t stop them entirely, we can take proven steps to significantly minimise these effects and make your recovery as comfortable and quick as possible.
Every patient’s healing journey is unique. This guide provides clear, medically-backed strategies to help you achieve the best possible outcome. Let’s walk through what to expect and how you can take control of your recovery.
Understanding Post-Surgical Bruising and Swelling
Bruising occurs when small blood vessels beneath the skin are disrupted during surgery, causing blood to leak into surrounding tissues. Swelling results from your body’s inflammatory response to surgical trauma, as increased blood flow and fluid accumulation work to promote healing. Both responses are essential parts of the recovery process and typically resolve within predictable timeframes.
Research demonstrates that multiple factors influence the severity and duration of post-surgical bruising and swelling, including individual healing capacity, age, skin type, surgical technique, and adherence to post-operative protocols. Understanding these factors helps set appropriate expectations for your recovery journey.
Clinically Proven Medical Treatments to Give You a Head Start
We use evidence-based medical interventions to actively manage bruising and swelling from the very beginning.
Tranexamic Acid (TXA) for Less Bruising
Tranexamic Acid represents one of the most effective tools we use for reducing post-facelift bruising. In simple terms, TXA helps your body’s natural clotting process work more efficiently after surgery. This antifibrinolytic medication works by preventing blood clots from breaking down, thereby reducing bleeding and subsequent bruising formation.
Clinical studies demonstrate that 83.6% of plastic surgeons report using TXA, with 63.2% observing significant reduction in post-operative bruising. TXA can be administered through multiple routes, with excellent safety profiles—92.4% of surgeons report no complications from its use.
Corticosteroids for Reduced Swelling
To manage initial swelling, we often administer a single dose of a corticosteroid (like dexamethasone) before your surgery. This is a powerful anti-inflammatory that gives you a head start on recovery. A single preoperative dose of 10mg dexamethasone has been shown to decrease both edema and bruising over the first two postoperative days, with effects most pronounced during the initial 48 hours.
Your Role in Recovery: At-Home Care
How you care for yourself after surgery plays a huge role in your results. These simple steps are essential.
The Power of Gravity: Why Keeping Your Head Up is Crucial
This may be the simplest yet most effective tip for reducing swelling. Keeping your head elevated uses gravity to your advantage, allowing fluid to drain away from your face. This prevents fluid from pooling in the tissues, which eases pressure and discomfort.
Elevated positioning uses gravity to encourage fluid drainage away from the surgical site, reducing tissue congestion and promoting more comfortable recovery.
Our Recommendations:
- Sleep Elevated: For the first two weeks, sleep with your head and shoulders propped up on 2-3 pillows. Aim for a 30-45 degree angle.
- Use a Recliner: Many patients find it easiest to sleep in a comfortable recliner for the first few nights.
- Avoid Bending Over: When you need to pick something up, bend at your knees instead of tipping your head down.
Cold Therapy: Your First Line of Defence
Applying cold packs immediately after surgery helps to narrow your blood vessels. This limits blood flow to the area, which reduces the amount of bleeding that causes bruising and swelling. The application of cold causes vasoconstriction, reducing blood flow to the area and limiting further bleeding that contributes to bruising formation.
How to Apply Cold Compresses:
- Protect Your Skin: Always wrap ice packs or frozen peas in a clean, thin towel. Never apply ice directly to your skin.
- Time it Right: Apply the compress for 10-15 minutes at a time, then take a 15-minute break.
- Be Consistent: Continue this cycle as much as possible during waking hours for the first 48 hours after surgery.
Fueling Your Recovery: Nutrition & Supplements
What you eat and drink has a direct impact on your body’s ability to heal.
Your Diet’s #1 Job: Fight Swelling by Cutting Salt
This is one of the most effective ways to control swelling. Salt avoidance represents one of the most effective dietary interventions for managing post-operative swelling. Excess salt (sodium) acts like a magnet for water, pulling fluid into tissues and making swelling worse.
Sodium fundamentally alters fluid balance in the body by creating osmotic forces that pull water into tissues. When you consume excess salt, your body retains extra sodium, which increases the amount of fluid outside of cells in the interstitial spaces.
Evidence-Based Guidelines:
- The Goal: Aim for less than 1,500mg of sodium per day for at least two weeks after surgery.
- What to Avoid: The biggest sources of hidden salt are processed foods, canned soups, frozen dinners, takeaway meals, and restaurant food.
- What to Eat: Focus on fresh, whole foods: fruits, vegetables, lean proteins (chicken, fish), and whole grains that you prepare at home.
- Read the Label: If it comes in a box or a can, check the nutrition label for sodium content.
Hydration and Dietary Optimization
Proper hydration plays a crucial role in recovery by helping your body eliminate excess fluid trapped in tissues. Aim to consume 6-8 glasses of water daily while increasing intake of fruits and vegetables with high water content.
Dietary recommendations:
- Focus on nutrient-rich whole foods including lean proteins for tissue repair
- Incorporate antioxidant-rich fruits and vegetables to combat inflammation
- Include omega-3 fatty acids to decrease post-surgical inflammation
- Avoid processed foods high in sodium that promote water retention
Helpful Supplements (With Your Surgeon’s Approval)
Bromelain: The Evidence-Based Choice
Bromelain, a natural enzyme found in pineapple stems, has been clinically shown to help reduce swelling and inflammation. This proteolytic enzyme works by breaking down proteins that trap fluids in tissues following surgical trauma, while also providing anti-inflammatory effects.
Clinical evidence: Multiple peer-reviewed studies support bromelain’s effectiveness, with research showing it can be as effective as NSAIDs in reducing postoperative inflammation. Clinical trials demonstrate statistically significant reductions in bruising area and swelling intensity when compared to placebo treatments.
Recommended protocol:
- We typically recommend an enteric-coated form (500mg twice daily)
- Begin 48 hours after surgery and continue for two weeks
- Must be taken on an empty stomach for optimal absorption
Vitamin C Support
Taking 1-2 grams of Vitamin C daily supports your immune system and helps your body build collagen, which is essential for tissue repair and healing. Vitamin C acts as a free-radical scavenger and promotes healing at the cellular level, generally well-tolerated with minimal side effects.
Arnica Montana
You may have heard of Arnica, a popular homeopathic remedy for bruising. While some patients feel it helps, the scientific evidence for facelift patients is inconsistent. Multiple randomized controlled trials in facelift patients found no significant subjective difference in bruising outcomes. Computer analysis showed minimal improvement in bruising area but no difference in color intensity.
Current evidence shows improvement in only 4 out of 13 studies evaluating arnica for post-procedure bruising. While it’s unlikely to cause harm, we prioritise treatments with stronger clinical evidence. If you are considering Arnica, please discuss it with us first.
Crucial Recovery Rules: Activity & Sleep
Activity Restrictions
Restrict Activity: Avoid all strenuous activities, vigorous exercise, and lifting anything heavier than 5 kilograms for at least two weeks. Physical exertion increases blood pressure and can aggravate developing bruises while potentially affecting surgical results.
Progressive activity guidelines:
- Weeks 1-2: Complete rest with light walking only
- Weeks 3-4: Gradual increase to light activities with surgeon approval
- Weeks 5-6: Return to normal activities based on individual healing progress
Sleep Position Requirements
Sleep on Your Back: Back-sleeping with your head elevated is non-negotiable for at least two to four weeks. Sleeping on your side or stomach puts direct pressure on your healing tissues, which can increase bruising and compromise your surgical outcome.
Critical Medication Management
Certain medications must be discontinued before and after facelift surgery to minimize bruising risk. Blood-thinning medications including aspirin, ibuprofen, and other NSAIDs should be avoided as directed by your surgeon.
Important safety note: Never discontinue prescribed blood thinners without explicit approval from your prescribing physician, as cardiovascular risks may outweigh surgical considerations.
Hematoma formation occurs in 1-8% of facelift procedures and requires emergency evaluation. A hematoma (a collection of blood under the skin) is the most common urgent issue and requires immediate evaluation. Prompt treatment is essential to protect your surgical results and prevent complications.
Your Recovery Timeline: Trust the Process
Bruising Resolution: Bruising is most visible in the first 2-3 days and will gradually fade over 7-14 days. Bruises typically progress through predictable colour changes from red or purple to green, yellow, and finally brown before disappearing completely.
Swelling Management: Swelling typically peaks around day 3-4. About 80% will resolve by weeks 3-4, but complete resolution may take several months as your body continues the healing process.
Final Results: You will see a wonderful improvement once the initial swelling subsides, but your final, refined results will continue to emerge over the next 6-12 months. While initial improvements are visible once swelling subsides, final surgical results typically become apparent at 3-6 months, with complete healing taking 6-12 months. Patience with the natural healing process is essential for optimal outcomes.
Professional Follow-Up Care
Never skip scheduled follow-up appointments with your surgeon. These visits allow professional monitoring of your healing progress and early identification of any complications requiring intervention. Even when recovery appears to be progressing well, these appointments remain crucial for optimal outcomes.
Your surgeon may recommend additional interventions based on your individual healing response, including lymphatic drainage massage once cleared for such treatments, typically 4-6 weeks post-surgery.
Managing Expectations and Individual Variation
Recovery experiences vary significantly based on multiple factors including age, skin elasticity, overall health status, and adherence to post-operative instructions. Some patients heal more quickly than others, and comparing your recovery to others’ experiences can create unnecessary anxiety.
Focus on following your surgeon’s specific instructions and maintaining realistic expectations about the healing timeline. While these evidence-based strategies can significantly improve your recovery experience, complete elimination of bruising and swelling is not possible, as these represent normal physiological healing responses.
Conclusion
A successful facelift recovery is a partnership between you and your surgical team. By understanding the healing process and actively following these evidence-based protocols, you can ensure a smoother, more comfortable recovery and enjoy your beautiful results sooner.
Remember, every patient’s journey is unique. The most important factor is strict adherence to the personalised care plan we provide for you. If you ever have a question or concern, please don’t hesitate to call us. When in doubt about any aspect of your recovery, always consult with your qualified plastic surgeon rather than relying solely on general information.
About Dr Scott J Turner
Dr Scott J Turner is a specialist plastic surgeon practicing at two convenient Sydney locations. With extensive experience in facial plastic surgery, Dr Turner is committed to providing patients with comprehensive education and evidence-based care protocols to support optimal surgical outcomes.
Sydney Clinic Locations:
For more information about Dr Turner’s qualifications and approach to patient care, visit Dr Scott J Turner – Sydney Plastic Surgeon.
Schedule a Consultation: To discuss your individual recovery needs and develop a personalised care plan, contact our practice to schedule a consultation with Dr Turner.
Medical Disclaimer
This information is for educational purposes only and does not replace professional medical advice. Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.