Preventing Bruising and Hematomas After Gynecomastia Surgery

Bruising occurs when small blood vessels (capillaries) are damaged during surgery, leading to blood leaking into surrounding tissue. Hematomas are more serious and occur when blood pools under the skin, often requiring drainage if not managed early.

Both can lead to discomfort, delayed healing, or even compromise the final aesthetic result if severe. That’s why prevention is key.

Preoperative Techniques to Minimize Bruising and Hematomas

Prior to male breast reduction surgery, it is important to maintain a high-protein diet that is rich in minerals and vitamins. Protein is an important building block in wound healing. Protein-rich foods include meats, dairy, and nuts. Vitamin C is an important vitamin that plays a critical role in collagen production and is vital to proper wound healing. Iron is a mineral that is important in the production of red blood cells, which carry oxygen to the body’s tissues from the lungs. Optimizing your diet prior to and after surgery will help give your body the support it needs to heal properly.

Intraoperative Techniques to Minimize Bruising and Hematomas

Meticulous Surgical Technique

Careful, deliberate tissue dissection and handling are fundamental. Minimally traumatic instruments and techniques are used to reduce vascular injury. Electrocautery is used judiciously to control bleeding from even the smallest vessels.

Controlled Liposuction

When liposuction is part of the procedure, small cannulas are used and most will avoid aggressive passes. Tumescent fluid is infused with a vasoconstrictor (epinephrine), which significantly reduces bleeding during fat removal.

Hemostasis Is Paramount

Before closing incisions, extra time and care is taken to achieve complete hemostasis. This includes re-checking the surgical field for any active or potential bleeders. Even the smallest vessel can lead to a hematoma if overlooked.

Medications that reduce blood loss

In addition to epinephrine, Transexamic Acid (TXA) is a medication that is given during surgery which has been shown to reduce blood loss and bruising. TXA works by preventing the body’s ability to break down blood clots so they stay in place.

Postoperative Measures for Patients

Wear Compression Garments

Properly fitted compression garments are crucial — they reduce space for fluid accumulation, support tissue adherence, and minimize swelling and bruising. Patients are instructed to wear them 24/7 (except for showers) for the first few weeks to months after surgery.

Avoid Early Physical Activity

Strenuous activity or arm movements too soon after surgery can disrupt healing vessels and increase the risk. It is highly advised to avoid workouts, heavy lifting, and raising the arms above shoulder level for at least 4-6 weeks post-op.

Sleep Elevated

Sleeping with the head and chest elevated (using 2–3 pillows or a wedge pillow) for the first week minimizes fluid buildup and promotes lymphatic drainage.

Monitor and Communicate

Patients should be instructed to contact their physician immediately if they notice one side of the chest becoming firm, swollen, or increasingly painful. Early intervention can often prevent a minor bleed from becoming a major hematoma.

Medications That Help Get Rid of Bruises

Arnica montana, or Arnica,  is an over the counter herb that has been shown to speed up the resolution of bruises. Arnica contains anti-inflammatory compounds that reduce swelling and improve blood flow. Arnica is available in a topical cream and oral pill.

Bromelain is a mixture of enzymes found in fruits like pineapple that have anti-inflammatory effects which help reduce bruising. Bromelain can also be taken as an oral supplement.

Medical Precautions

Medication Review

Your surgeon should carefully review the patient’s medications and supplements preoperatively. Blood thinners (like aspirin, NSAIDs, and certain herbal supplements such as ginkgo or fish oil) must be stopped 1–2 weeks before surgery, with physician approval if prescribed.

Smoking and Alcohol Cessation

Smoking and alcohol can impair healing and increase the risk. Patients are required to abstain from both for several weeks before and after surgery to support optimal outcomes.

If you’re considering male plastic surgery, choosing a board-certified plastic surgeon with extensive experience in male chest contouring is paramount. Don’t hesitate to ask about their strategies for complication prevention.

For questions or consultations about male plastic surgery, feel free to contact HIM Plastic Surgery today. Together, we can plan for a safe procedure and smooth recovery.