What To Do with Your Herbal Medications for Upcoming Plastic Surgery
The past five years has seen the two societal trends come together…..an increase in the number of elective plastic surgery procedures….and….the availability and daily use of herbal medications. Numerous surgical complications have been implicated from certain herbs. The most common herbs implicated are Echinacea, Ephedra, Garlic, Ginseng, Ginkogo, Kava, St. John’s Wort, and Valerian. They may adversely effect anesthetic drugs, prolong bleeding and impair healing after surgery. As a result, I have admonished my plastic surgery patients to stop taking any of these herbs, as well as aspirin-containing drugs and any nicotine products, two weeks before any plastic surgery procedure.
In a recent December 2007 report in the prestigous journal, Plastic and Reconstructive Surgery, a study out of the Division of Plastic Surgery in University of Missouri in Columbia put some hard scientific scrutiny to the effects of certain herbal medications on the effects of platelet function (bleeding) after surgery. Using human volunteers, the effects five herbal medications compared to aspirin were tested by blood samples after two weeks of taking them. Surprisingly, the herbal medications (Ginkgo biloba, garlic, Asian ginseng, St. John’s Wort, and saw palmetto) did not affect platelet function while aspirin did so dramatically. I give kudos to this group for taking the effort to look at a commonly held perception with some factual evdience.
Does this mean I will no longer pay attention to the herbs my patients are on? No…..as the study did not evaluate Echinacea, Ephedra, Kava, and Valerian on my hit list. Only garlic, St. John’s Wort, and Ginkgo biloba were exonerated. Perhaps they will evaluate these herbs in the future. I will still tell my patients to go off any herbs two weeks prior to surgery. But I will rest easier knowing that some of them are not harmful to their plastic surgery procedure outcome and, even if the patient only stopped a few days before surgery, will likely not be a problem.
Dr. Barry Eppley