Key points
- Swelling and bruising commonly occur as part of the normal inflammatory process after surgery, and when they are severe, recovery can be delayed and satisfaction can be lower [1].
- In a Cochrane review that pooled rhinoplasty studies, there was some evidence that steroids given around the time of surgery reduce swelling during the first two days, but the difference did not last beyond that, and the quality of the evidence was low [1].
- Arnica showed results leaning toward reduced bruising after rhinoplasty and facelift, but methods varied greatly between studies, so more research is needed on its safety and how it should be taken [2].
- Some supplements have been reported to be linked to a risk of bleeding, so you must tell your medical team about every product you are taking or plan to take [3].
- How quickly swelling goes down depends on the extent of surgery and your constitution, so it is safest to decide on your recovery plan and care methods with your surgeon.
Why do swelling and bruising occur?
When tissue is injured during surgery, the body sets off an inflammatory response and begins to heal the wound. A Cochrane review explained that this normal inflammatory process commonly causes swelling (edema) and bruising (ecchymosis), and that when they are severe, full recovery can be delayed and satisfaction with the surgery can be lower [1].
A review of rhinoplasty said that swelling and bruising around the eyes are the problems that bother rhinoplasty patients most, and that their severity is influenced by many factors [4]. Even with the same surgery, how much swelling there is and how quickly it goes down differ from person to person depending on the extent of surgery, the condition of the tissue, and constitution.
Do steroids reduce swelling?
A 2014 Cochrane systematic review of steroids (corticosteroids) given around the time of facial plastic surgery analyzed 10 randomized controlled trials with 422 participants, 9 of which were rhinoplasty studies [1]. There was some evidence that steroids reduce swelling during the first two days after surgery, but the difference did not last beyond that [1]. Only 2 studies with 60 participants could be combined in a meta-analysis, and the quality of the evidence was low [1].
Results for bruising were inconsistent across studies, and some studies had conflicting results [1]. In 1 study that used a high dose (40 participants), both swelling and bruising were reduced between days 1 and 7 after surgery, but the authors stated that it is unclear how clinically meaningful this reduction is and that there is little evidence on safety [1]. Only 1 study evaluated a facelift, and in that study steroids did not reduce swelling [1]. The authors concluded that the current evidence does not support using steroids to prevent complications after facial plastic surgery [1].
A 2013 systematic review also summarized that after rhinoplasty, steroids reduced swelling and bruising only for a short period of less than 2 days, with no long-term reduction [5]. The facelift literature also showed no clear reduction, and this review concluded that the use of steroids after surgery is not justified [5]. However, it said that in body contouring surgery, steroids reduced nausea and vomiting after surgery when used together with other treatments [5].
What is known about cold compresses, compression, and supplements
A 2026 review of outpatient facial surgery in younger patients described an emphasis on compression, cold compresses, and supplements to shorten recovery and reduce swelling [6]. However, these are care methods described in a narrative review, and the research summary contains no figures comparing their individual effects.
A 2020 systematic review of arnica and bromelain included 29 papers [2]. Arnica appeared to reduce bruising after facial surgery such as rhinoplasty and facelift, and several studies supported bromelain as reducing difficulty opening the mouth, pain, and swelling after removal of molars [2]. In contrast, arnica applied to the skin after eyelid surgery had no effect, and the types of surgery, the ways the products were taken, and the results varied greatly between studies [2]. The authors said that more research is needed to clarify the safety and effectiveness of dosing regimens and interactions with other medications [2].
A 2019 systematic review of complementary therapies in cosmetic surgery patients found level II evidence supporting the use of arnica to reduce swelling after rhinoplasty [3]. The same review also summarized level V (low-level) reports linking the intake of ginkgo and kelp to a risk of bleeding [3]. Around the time of surgery, it is best to tell your medical team about supplements and discuss them just as you would medications.
Research on medications that reduce bleeding
In facelift surgery, bleeding during and after surgery is cited as one of the most common risks [7]. A 2023 scoping review of tranexamic acid, a medication that helps stop bleeding, in facelift surgery examined 8 papers and summarized its possible benefits for blood loss, drainage volume, swelling, bruising, operating time, and other outcomes [7].
However, the authors stated that information on this topic is still limited, and said that more prospective studies across multiple institutions are needed to develop evidence-based guidelines on the route of administration and dose [7]. Whether to use such medications is judged by the medical team based on the type of surgery and the patient's health.
Nasal tip swelling that lingers after rhinoplasty
After rhinoplasty, swelling in the area just above the tip of the nose can sometimes be a problem. A 2016 review of injection treatments for the nose explained that steroid injections have a role in preventing swelling above the tip (supratip swelling) after nasal reconstruction [8].
The same review warned that rare but serious complications involving impaired blood flow to the eyes and brain can occur with any substance injected into the nose [8]. Whether you need an injection treatment in your nose should be judged by the surgeon who performed your surgery after checking your progress.
When to see a doctor, and what to check during your consultation
Most swelling goes down gradually over time. However, if one side suddenly swells badly, the pain keeps getting worse, warmth and redness increase, or you notice any problems with your vision or breathing, it is safest not to wait but to contact the clinic where you had surgery. During your consultation before surgery, it is a good idea to check the following.
- How much swelling and bruising to expect for the extent of your surgery
- When and how to use cold compresses and compression
- The medications and supplements you take, and whether to stop them before and after surgery
- Symptoms after surgery that mean you should contact the clinic right away
- The schedule of visits to check your progress
Frequently asked questions
- Is there a set way to make swelling go down faster?
- There is some evidence that steroids reduce swelling during the first two days, but the difference did not last beyond that, and the quality of the evidence was low [1]. Cold compresses and compression are described as recovery care methods, but the sources reviewed contain no figures comparing their effects [6]. Care methods can differ from surgery to surgery, so it is best to follow your surgeon's instructions.
- Can I take supplements such as arnica?
- Arnica has shown results leaning toward reduced bruising and swelling after rhinoplasty and other facial surgery, but methods varied between studies, so more research is needed on its safety and how it should be taken [2, 3]. Some ingredients, such as ginkgo, have been reported to be linked to a risk of bleeding [3]. Talk with your medical team before taking any supplement, and if you are already taking one, you must let them know.
- How long does swelling last?
- The sources reviewed do not give figures for how long swelling lasts after each type of surgery. The severity of swelling and bruising is described as being influenced by many factors [4]. It is best to check with your surgeon about the course you can expect after your own surgery.
References
- da Silva EM, Hochman B, Ferreira LM. Perioperative corticosteroids for preventing complications following facial plastic surgery. Cochrane Database Syst Rev. 2014.PubMed 24887069DOI
- Knackstedt R, Gatherwright J. Perioperative Homeopathic Arnica and Bromelain: Current Results and Future Directions. Ann Plast Surg. 2020.PubMed 31800557DOI
- Ruan QZ, Chen AD, Tran BNN, et al. Integrative Medicine in Plastic Surgery: A Systematic Review of Our Literature. Ann Plast Surg. 2019.PubMed 30557187DOI
- Tasman AJ. Reducing Periorbital Edema and Ecchymosis after Rhinoplasty: Literature Review and Personal Approach. Facial Plast Surg. 2018.PubMed 29409099DOI
- Pulikkottil BJ, Dauwe P, Daniali L, et al. Corticosteroid use in cosmetic plastic surgery. Plast Reconstr Surg. 2013.PubMed 23985647DOI
- Morrissette M, Stein E, Tai K, et al. In-Office Surgical Procedures for Prejuvenation. Facial Plast Surg. 2026.PubMed 42379225DOI
- Soltany A, Alhallak N, Al Aissami M. Tranexamic acid in rhytidectomy: a scoping review. Ann Med Surg (Lond). 2023.PubMed 37811108DOI
- Thomas WW, Bucky L, Friedman O. Injectables in the Nose: Facts and Controversies. Facial Plast Surg Clin North Am. 2016.PubMed 27400851DOI
This article is an English translation of general health information that DOY JUN Plastic Surgery compiled in Korean from the summaries (abstracts) of papers in international academic journals. Treatment methods and results vary depending on each person's condition, so please consult a specialist for an accurate diagnosis and treatment plan.
