NSAIDs, Painkillers and Bruising in Facial Harmonization (HOF)

"Doctor, I only took one metamizole yesterday." The sentence comes up at the follow-up visit, with the bruise already formed, and opens a discussion about cause that rarely has a single answer. Common medications, from painkillers to anti-inflammatories, affect bleeding in different ways, and the professional who organizes the medical history and the patient guidance lowers the chance of surprises, without promising that a bruise will not happen. This guide covers what to ask, what to advise and what should never be changed on one's own. Medications and clinical decisions belong to the licensed professional and the prescribing physician, in line with the package insert and the rules of their professional board.

Anti-inflammatories, painkillers and bleeding: the essentials

It helps to separate the classes, because their effect on bleeding is not the same.

This table is a review reference, not a prescription. Individual effects vary, and the patient's assessment prevails.

What to ask in the medical history

Many patients do not think of a painkiller or a supplement as "medication." A list of targeted questions solves that.

The context of the medical history in HOF applies to everyone, and the patient record should capture the answers.

What to advise before the procedure

The guidance needs to be clear, written down and coordinated with the prescriber whenever a prescribed medication is involved. Some practices, always at the professional's discretion:

1. Inform the patient when booking about the medications and supplements they should mention.
2. Give written guidance on what to avoid on their own (for example, self-medicating with anti-inflammatories without need) and what to ask the prescribing physician.
3. Ask again on the day, because the situation changes between booking and the session.
4. Decide the plan based on what the patient actually took.

What to advise after the procedure

The post-procedure period also involves medications, mainly for pain and discomfort.

• Mild pain: many protocols use a simple painkiller and avoid, in the first hours, those that affect bleeding, according to the prescription.
• Swelling: cold compresses and relative rest are usually advised, depending on the area.
• Warning signs: intense pain, pallor, a lace-like (reticulated) discoloration, rapid increase in volume and visual changes call for immediate contact.
• Self-medication: tell the patient to contact the clinic before taking anything new on their own.

The full content is in post-procedure instructions and prescribing after HOF procedures.

What about arnica, bromelain and other "helpers"?

Many patients ask whether taking arnica or bromelain beforehand reduces bruising. The discussion requires care and is in arnica, bromelain and bruising. What is worth stressing here is that supplements are also medications for medical history purposes and can affect bleeding, so the patient should report their use.

How to handle the conversation about bruising

Bruising is the most frequent complication and the one patients fear most because of its appearance. The conversation needs to cover three points: what can happen, what can make it worse and what to do.

Documentation

Record the medications and supplements, the conversation, what was advised, the decision made and the warning signs explained. The informed consent should mention ecchymosis and bruising. See the structure in patient records and documentation in HOF. For cases with a complication, the overview is in safety and complications: overview.

Where Harmy fits in

Common mistakes

1. Asking only "do you take any medication?". The generic question misses yesterday's painkiller and this week's supplement. Ask by class.
2. Advising the patient to stop a prescribed medication. Chronic pain, heart disease and other conditions are reasons for the use, and the decision belongs to the prescriber.
3. Forgetting the aftercare. A patient who took an anti-inflammatory on their own after the session may develop a bruise that nobody connects to it.
4. Treating every bruise as cosmetic. Intense pain, tension and pallor call for assessment.
5. Failing to document. Without notes, the conversation about cause turns into opinion.

Written guidance for the patient

A short sheet, handed over when booking and reinforced on the day, prevents most misunderstandings. It can include: the list of medications and supplements the patient should report; the warning that prescribed medications must not be stopped without talking to the doctor; the recommendation to contact the clinic before taking anything new after the procedure; the warning signs of a significant bruise; and the clinic's contact details. The exact wording, tone and recommendations are up to the clinic, in line with the rules of its professional board. What matters is that the patient takes home what was discussed, and that the patient record shows they received it.

When a bruise needs more than guidance

Small, superficial bruises usually just call for patience. Those that grow after the first hours, harden, hurt a lot or come with pallor, warmth or fever deserve an in-person reassessment the same day. In those cases, document the progression, take photos and decide the course of action based on the clinical picture and the clinic's protocol. Giving the patient this guidance before discharge reduces anxiety and speeds up contact when it is truly needed.