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Marks That Look Like Persistent Bruising After Bleph, Browlift and Mini-face Lift?

In our Bay Area practice, we perform facelifts quite frequently. Some bruising and discoloration are a normal part of the healing process, and most bruising resolves within the first few weeks after surgery. In the early postoperative period, Arnica has strong anecdotal support for helping bruising resolve more quickly, although scientific evidence for its effectiveness is limited. If the darker discoloration persists beyond that period, some of it may be related to residual hemosiderin, a pigment left behind in the soft tissues as blood from the bruising breaks down. This can sometimes take longer to fade, even after the underlying bruising has resolved. Time is also an important part of the healing process. Even after the bruising has resolved, residual discoloration can continue to fade gradually as the hemosiderin is cleared from the tissues. In some cases, this improvement can continue for many months and occasionally up to a year.

Clinical Context

Bruising and lingering discoloration are actually two different processes. Fresh bruising is blood under the skin that your body reabsorbs within a few weeks. The yellow-brown staining that sometimes follows is caused by hemosiderin, an iron pigment left behind as that blood breaks down. Because eyelid and brow skin is thinner, staining there can be more noticeable and take longer to clear than in areas with thicker skin, like the cheeks or neck.

Answered by Dr. Steven Williams, President Emeritus of ASPS

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