Herbal supplements and plastic surgery don't mix well

Feb 14 2006

Natural herbal supplements are supposed to help boost our immune systems, give us more energy and make us generally healthier.

However, many of these "harmless" supplements could cause dangerous side effects during plastic surgery, reports a study in February's Plastic and Reconstructive Surgery., the official medical journal of the American Society of Plastic Surgeons (ASPS). In fact, the study found approximately 55 percent of plastic surgery patients, compared to 24 percent of the general public, take supplements but often do not tell their surgeons.

"When patients are asked about the medications they are taking, many do not mention medicinal herbs because they assume that they are safe," said ASPS member James Bradley, MD, study co-author, University of California, Los Angeles. "What many unsuspecting patients don't know is that the natural herbs they are taking may cause serious complications during and after surgery."

All 55 percent of plastic surgery patients who used herbal supplements took at least two different supplements and at least one on a daily basis. The most popular herbal supplements were chondroitin (18 percent), ephedra (18 percent), echinacea (14 percent) and glucosamine (10 percent).

• Chondroitin is often used to treat osteoarthritis. People using chondroitin may suffer from bleeding complications during surgery, particularly when used in combination with doctor-prescribed blood-thinning medications.
• Ephedra has been known to promote weight loss, increase energy and treat respiratory tract conditions such as asthma and bronchitis. This agent has been banned by the U.S. Food and Drug Administration (FDA) because it can raise blood pressure, heart rate and metabolic rate, ultimately causing heart attacks, heart arrhythmia, stroke and even death.
• Echinacea is often used for the prevention and treatment of viral, bacterial and fungal infections, as well as chronic wounds, ulcers and arthritis. However, it can trigger immunosuppression, causing poor wound healing and infection.
• Glucosamine, often offered in conjunction with chondroitin, contains chemical elements that mimic human insulin, and may artificially cause hypoglycemia during surgery.
• Other common supplements taken by patients in the study that may cause dangerous side effects included gingko biloba, goldenseal, milk thistle, ginseng, kava and garlic.

In addition to having a greater tendency toward taking herbal supplements, 35 percent of plastic surgery patients were more likely to engage in homeopathic practices, including acupuncture, hypnosis, chiropractic manipulation, massage, yoga and Pilates. Only six percent of the general population practiced homeopathics on a weekly basis.

"Patients should tell doctors about all of the medications they are taking - natural or prescribed. Only then can we safely suggest the appropriate discontinuation period, which can range from 24 hours to one month," said Dr. Bradley. "Taking this precaution is essential to a safe surgery and smooth recovery."

For referrals to ASPS Member Surgeons certified by the American Board of Plastic Surgery visit www.plasticsurgery.org.