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Are Herbal Supplements Putting Aesthetic Surgery Patients At Risk?
(press release from ASAPS)
For many people, the words "natural" or "herbal" are virtually synonymous
with safety and purity. Products available over-the-counter without a doctor's
prescription are often mistakenly believed to be free of significant risks. A
report in the March/April issue of Aesthetic Surgery Journal warns that
more than 40% of plastic surgery patients use herbal supplements in the two
weeks prior to undergoing surgery. And, while some herbal supplements may
provide benefits during recovery, commonly used herbal medications such as
ginkgo biloba, ginseng, garlic, echinacea, valerian root and others can have
deleterious effects when combined with surgery. When undergoing plastic surgery,
the most significant and potentially dangerous effects of alternative medicines
occur during the operative and immediate postoperative periods. "In considering
the dizzying array of supplements available, the main concerns of the plastic
surgeon are interaction with other medications, cardiovascular effects,
alteration of coagulation [bleeding] and sedative effects," says David J. Rowe,
MD, lead author and Assistant Professor of Plastic Surgery at University
Hospitals Case Medical Center, Lyndhurst, OH.
Unfortunately, as many as 70% of patients may not disclose the use of
alternative medications to their surgeon or conventional health care provider,
sometimes because they feel these physicians have little knowledge or interest
in naturopathic medicine, or they feel physicians may disapprove of such
treatments. Some patients simply fail to recognize the relevance of supplement
usage to their current medical or surgical care. Patients need to be aware that
full disclosure of all medications - both those that are prescribed and those
that are obtained over-the-counter - is extremely important to their health and
safety. They should also understand that inconsistent and unregulated
manufacturing standards and lack of regulation for many herbal supplements mean
that quality and dosage may vary considerably among products.
"This article was written to help plastic surgeons and their patients identify
potentially harmful herbal supplements, based on the most current scientific
research," says Dr. Rowe. "On the positive side, we also discuss how providing
the correct supplements and nutrients after aesthetic surgery can be very
The authors recommend that patients be provided with a comprehensive list of
supplements that must be avoided in the perioperative period to minimize
potential surgical complications.
"Despite the fact that the dangerous side effects of some herbal supplements
have been widely publicized, plastic surgeons still find that many patients do
not fully appreciate the importance of discontinuing these treatments before
surgery," says Alan Gold, MD, president of the American Society for Aesthetic
Plastic Surgery (ASAPS). "Physicians must have at least fundamental knowledge of
the common herbal medications and their effects, and then be very proactive in
discussing patients' use of herbal supplements during the history, consultation
and informed consent process. Stopping certain herbal supplements prior to
surgery is just as critical as stopping aspirin, ibuprofen and many other common
Aesthetic Surgery Journal, owned by the American Society for Aesthetic
Plastic Surgery and published by Elsevier Science, is a peer-reviewed
international journal focusing on clinical and scientific developments in
cosmetic surgery and cosmetic medicine. The Journal has subscribers in more than
80 countries. Besides its affiliation with ASAPS, the leading organization of
board-certified plastic surgeons who specialize in aesthetic surgery, ASJ is
also the official English-language journal of plastic surgery societies in
Brazil, Israel, Mexico, Japan, Korea, Thailand, Costa Rica, Colombia, India and
The Netherlands, and it is the official journal of the Rhinoplasty Society.
ASJ's Editorial Board includes plastic surgeons and Interspecialty Editors
representing anesthesiology, dermatology, ophthalmology, otolaryngology and
clinical psychology. For information on the Journal, as well as subscriber and
pay-per-view access to the Journal's full text and graphics, go to
The American Society for Aesthetic Plastic Surgery, the leading organization of
board-certified plastic surgeons specializing in cosmetic plastic surgery
includes Active-Member plastic surgeons certified by the American Board of
Plastic Surgery or the Royal College of Physicians and Surgeons of Canada, as
well as International Active Members who hold equivalent credentials in their
own countries. For information, visit
The 2400-member American Society for Aesthetic Plastic Surgery (ASAPS), founded
in 1967, is the leading organization of ABMS-certified plastic surgeons who
specialize in cosmetic plastic surgery. With ASAPS active members certified by
the American Board of Plastic Surgery, Canadian active members certified by the
Royal College of Physicians and Surgeons of Canada, and International members
certified in their countries of origin, ASAPS is at the forefront of innovation
in aesthetic plastic surgery. Toll-free referral line: 888.ASAPS.11 (272.7711).
American Society for Aesthetic Plastic Surgery
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