Could Herbal Supplements Endanger Aesthetic Surgery Patients?

A new article warns that commonly used herbal medications such as ginkgo biloba, ginseng, garlic, echinacea, valerian root, and others could have harmful effects when combined with surgery.

Surgeons at University Hospitals Case Medical Center (Lyndhurst, OH, USA) warn that more than 40% of plastic surgery patients use herbal supplements in the two weeks prior to undergoing surgery. Unfortunately, as many as 70% of patients may not disclose the use of alternative medications to their surgeon or doctor, often because they feel that conventional physicians have little knowledge or interest in naturopathic medicine, or because they feel that the physicians may disapprove of such treatments. Other patients may simply fail to recognize the relevance of supplement usage to their current medical or surgical care. The authors stress that 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, since the most significant and potentially dangerous effects of alternative medicines occur during the operative and immediate postoperative periods. 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. The authors also recommend that patients be provided with a comprehensive list of supplements that must be avoided in the perioperative period to minimize potential surgical complications. The article was published in the March/April 2009 issue of Aesthetic Surgery Journal.

"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," said lead author David Rowe, M.D., an assistant professor of plastic surgery. "On the positive side, we also discuss how providing the correct supplements and nutrients after aesthetic surgery can be very therapeutic."

"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," said Alan Gold, M.D., president of the American Society for Aesthetic Plastic Surgery (ASAPS, Garden Grove, CA, USA). "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 drugs."

Related Links:
University Hospitals Case Medical Center
American Society for Aesthetic Plastic Surgery