Ask the Plastic Surgeons

Q. I’m interested in receiving rejuvenating injectable procedures to enhance my appearance, but I’m concerned about bruising. Can you explain how I can alleviate and/or diminish this condition?

A. In our practice, we make a point to advise our patients to take precautions to avoid bruising by ensuring the injectable products yield the

desired results without the side effects commonly associated with these procedures. This entails discussing the procedure thoroughly with your physician in advance of the procedure to achieve maximum results.

Since the areas are generally very vascularized, bruising can occur if the injection passes through blood vessels, which can then cause blood to leak into surrounding areas. We recommend that 10 days prior to your injectable procedure, avoid aspirin, Advil, Aleve, Motrin and ibuprofen. These over-the-counter pain medications can thin the blood and cause bruising. If you have a headache, we recommend taking Tylenol (acetaminophen).

It’s most important to note that to alleviate the bruising condition you must choose a physician that engages a trusted and experienced injector. In addition, to avoiding the above mentioned over-the-counter drugs, you should also abstain from particular prescription medications, such as Coumadin, Heparin and Persantine (but avoid stopping these medications without permission from your prescribing physician), elevate your head while sleeping after receiving injections and use ice before, during and after your injections. Finally, if you have a significant event coming up on your schedule, make sure your injections are at least two weeks ahead of time to allow for sufficient recovery.

Some supplements also help to prevent bruising, such as arnica and bromelian. Alternatively, there are supplements that increase bruising and should be avoided prior to any injectable procedure, such as gingko biloba, ginseng, omega-3, St. John’s Wort and Vitamin E. Green tea has also been proven to increase the propensity for bruising, so we recommend switching to another beverage ten days prior to your procedure. And 24 hours before you receive treatment, avoid any use of alcohol.

We take extra precautions in our practice to ensure that all physicians and nurses assigned to injectable procedures are certified to conduct these functions to the highest medical protocols and strongly recommend ensuring your physician of choice adheres to similar standards.

John Smoot, MD, is Chief of Plastic Surgery at Scripps Memorial Hospital-La Jolla and Wendell Smoot, MD, has been voted by his peers as Top Doctor in San Diego for five consecutive years. Carol Hollan, MD, is San Diego’s first female board-certified plastic surgeon while Reza Sadrian, MD, is one of very few plastic surgeons dually certified in plastic and reconstructive surgery as well as oral and maxillofacial surgery. The practice has over 20 years of tenure in the industry and each is individually board certified by the American Board of Plastic Surgery.