What's actually happening
Bruising is extravasated blood under the skin. During surgery, small vessels are inevitably disrupted; the released blood pools in the surrounding tissue and is gradually reabsorbed by macrophages. The color progression — purple → blue → green → yellow → resolved — reflects haemoglobin breakdown.
Bruising peaks at days 2–3 (when extravasation is complete and reabsorption hasn't started in earnest) and resolves at days 10–14.
Swelling is interstitial fluid accumulation. Surgical trauma produces inflammatory mediators that increase capillary permeability — fluid leaks into surrounding tissue. Swelling peaks at days 2–3 and resolves over weeks to months, with the deep component continuing to settle through month 6.
Different timelines, different management
For bruising:
- Cold compresses days 0–3 (slows extravasation)
- Warm compresses days 4+ (increases blood flow, accelerates reabsorption)
- Arnica may help marginally
- Time is the dominant factor
For swelling:
- Head elevation while sleeping (gravity effect, very significant)
- Reduced salt intake
- Avoid stooping and lifting
- Bromelain may help marginally
- Lymphatic drainage massage helpful from week 3+ (not before)
What doesn't work despite popular belief
- Vitamin C megadosing
- Specific "anti-inflammatory" diets
- Topical bruise creams (some marginal benefit but not the dramatic effect marketed)
- Lasers in the first 2 weeks (can disturb healing)
Frequently asked questions
How asymmetric is bruising allowed to be?
Quite asymmetric — about half of patients have visibly different bruising between sides. Doesn't predict the final cosmetic outcome.
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