For many years now, we have recognized the potential conflicts between natural dietary supplements, herbal products and vitamins. Most individuals don’t think of these products as ‘medicines’ and very few will tell us they are taking them, even though they feel that like any other medication these products will have certain health benefits. What is important to understand that just like a prescribed medication, dietary supplements can have unintended side effects. These side effects are often unnoticed, unless of course, there is a cosmetic procedure involved.

The Food and Drug Administration, or FDA, is responsible for certifying that any medication is both safe and effective for its intended purpose. However, when it comes to nutritional and herbal supplements the FDA must show only that the product is unsafe to the public. Even if the dietary supplement is not effective, it may stay on the market despite the fact that the science does not measure up. There are many examples such as zinc for colds, selenium for the prostate, gingko for memory, chondroitin sulfate for joints, garlic for digestion, calcium for bone health, and St. Johns Wort for insomnia, to name a few.

Problems that we encounter with herbal supplements relate to bleeding and bruising after a procedure. Our personal experience involves garlic supplements, high daily intake of vitamin E, and ephedra which was taken by an individual as a natural appetite suppressant. Unexpected bleeding and bruising is unpleasant for both surgeon and patient and our office has since included a list of ‘good’ and ‘bad’ herbal supplements in our pre-procedure teaching packet. As often is the case, we don’t know the reason for the side effects, but a recent publication in the January issue of Plastic and Reconstructive Surgery out of Case Western Reserve has identified a list of herbal products which are linked to an increase in blood pressure. How this happens will vary, however the result can be the same, increased blood pressure and more bleeding and bruising.

The bottom line is that when it comes to safe cosmetic surgery, herbal supplements should be considered ‘real medications’ with real side effects. Though supplements are considered safe by the FDA, the safety just might not include surgery in the equation. Be certain to tell your doctor and surgeon about any herbal supplements you are taking, or even planning to add to your daily regimen Ask your doctor for a list of supplements which might cause problems, and at best, plan to discontinue any unnecessary supplements at least two weeks before cosmetic surgery. You might be glad that you did.