Millions of Americans routinely take herbal products, homeopathic medicines and dietary supplements, but these so-called “natural” products may increase risk of bleeding during and after cosmetic surgery.

Part of the onus falls on plastic surgeons to make sure they know what their patients are taking. New research in the March issue of the Aesthetic Surgery Journal makes it easier for surgeons to do this by highlighting the riskiest supplements and providing some important pre- and post-operative guidelines regarding their use.

According to the study, risky herbs and supplements include:

  • Chinese peony
  • Garlic
  • Ginger
  • Ginko
  • Ginseng
  • Oil of wintergreen (methyl salicylate)
  • Saw palmetto (Serenoa repens, Salbalserrulata)

Physicians should carefully screen patients for supplement use and advise complete cessation of supplements 2 to 3 weeks before surgery, as well as postponement of supplement use after surgery, the study authors write.

“It is essential that plastic surgeons be aware of the popular, ‘natural’ products that have potentially dangerous bleeding effects.,” says lead author Subhas C. Gupta, MD, CM, PhD , chairman of the department of plastic surgery at Loma Linda University School of Medicine in Loma Linda Calif, in a press release. “Questions surgeons may want to ask their patients include whether the patient is taking any vitamins, herbs or supplements; what vegetables or plant products the patient has been eating in the past month; what types of teas the patient has been drinking recently; and whether the patient has ever taken any herbs or supplements in the past,” he says.

“Many patients don’t disclose their intake of herbs or supplements, and they are often not aware of the risk of complications, which can seriously compromise surgical outcomes and patient safety,” agrees Foad Nahai, MD, the journal’s editor-in-chief, in a press release. “This review will help plastic surgeons appropriately counsel their patients. It provides an excellent overview of our current knowledge about many popular supplements, recommendations for discussing supplement consumption with patients, and recommendations for managing supplement use in the preoperative and postoperative setting.”

Source: Aesthetic Surgery Journal