Supplements to be avoided

Supplements to be Avoided

The following list contains the most common over-the-counter supplements that are taken by plastic surgery patients. They may all have adverse effects on your post-operative course and are best avoided. Please peruse this list and follow the recommendations about discontinuing their use.

Chondroitin Sulphate (Arthroguard, Oseto-eze)

  • Peri-operative bleeding
  • Discontinue 2–3 weeks before surgery

Glucosamine (Arthroguard, Oseto-eze)

  • Hypoglycemia
  • Discontinue 2–3 weeks before surgery

Ephedra (Ma-huang)

  • Hypertension & cardiac instability with anaesthetics
  • Discontinue 1 day before surgery

Echinacea (Echinaforce)

  • Potentiates anaesthetic toxicity, allergic reaction, immunosuppression
  • Discontinue 2–3 weeks before surgery

 Ginkgo biloba

  • Post-operative sedation, Peri-operative bleeding
  • Discontinue 1-2 days before surgery

 Goldenseal (Hydrastasis canadenis)

  • Volume depletion, postoperative sedation, photosensitization
  • Discontinue 2–3 weeks before surgery

Milk thistle (Silybum marianum)

  • Volume depletion (choleretic activity)
  • Discontinue  2–3 weeks before surgery

 Ginseng

  • Peri-operative bleeding; avoid use in children and pregnant women
  • Discontinue 1 week before surgery

Kava Root

  • Post-operative sedation
  • Discontinue 1 day before surgery

Garlic 

  • Peri-operative bleeding
  • Discontinue 1 week before surgery

 Saw palmetto

  • Peri-operative bleeding
  • Discontinue 2–3 weeks before surgery

 St. John’s Wort

  • Sedation, low blood pressure, photosensitization and swelling
  • Discontinue 5 days before surgery

Valerian (Valeriana officinalis)

  • Postoperative sedation
  • Discontinue 1 week before surgery

Ginger (Zingiber officinale)

  • Peri-operative bleeding
  • Discontinue 2–3 weeks before surgery

Eicosapentaenoic acid (fish oil)

  • Peri-operative bleeding
  • Discontinue 2–3 weeks before surgery

Vitamin E  

  • Peri-operative bleeding, prolonged wound healing
  • Discontinue 2-3 weeks before surgery

Source : Top-10 List of Herbal and Supplemental Medicines Used by Cosmetic Patients: What the Plastic Surgeon Needs to Know. Heller, J et al, PRS, 2006, 117(2) 436 – 445.