Plastic Surgery
Dr. Barry Eppley

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Herbal Medications and Plastic Surgery

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


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Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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