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    Herbs Not Be Used Before Plastic Surgery

    By Margarita Nahapetyan

    Plastic Surgery patients should not be taking any herbal dietary supplements prior to the undergoing surgery as they can have negative effects when combined with the operation, warns a report published in the latest issue of Aesthetic Surgery Journal.

    The report claims that more than 40 per cent of cosmetic surgery patients take some form of herbal supplement two weeks prior to their surgery. For many people, the words "natural" or "herbal" are associated with health, safety and purity. However, use of the over-the-counter products without a doctor's prescription often results in significant risks for health. According to the report, as many as 70 per cent of individuals may not even tell their surgeon or conventional health care provider that they have been using alternative medications, sometimes because they feel that these doctors have little belief or interest in naturopathic medicine, or they feel that their physicians may not be quite supportive of such treatments.

    According to Dr. David J. Rowe, MD, main author and Assistant Professor of Plastic Surgery at University Hospitals Case Medical Center, Lyndhurst, OH, some patients simply do not understand the relevance of herbal supplement usage to their current medical or surgical care. Patients need to be aware that full disclosure of all medications - both those that are prescribed and those that are obtained without any prescription - is very important for their own sake. It is also important that people realize that constantly changing and unregulated manufacturing standards and lack of regulation for many alternative drugs mean that quality and dosage may vary significantly among these products.

    When undergoing plastic surgery, the most significant and potentially hazardous effects of alternative medicines occur during the operative and immediate postoperative periods. Some herbal supplements can help with the recovery process, but the experts are worried that others can be harmful around the time of the operation and may also interact with traditional medication. These include some of the mostly used herbal supplements, which, after the interaction, can cause deleterious cardiovascular effects, alteration of coagulation [bleeding] and sedative effects.

    Herbal medications to avoid 2 weeks prior to surgery are:

    1. Bleeding effects: Gingko Biloba, Garlic, Ginseng, Fish oils (omega-3 fatty acids), Dong Quai, Feverfew.

    2. Drug interactions: Echinacea, Goldenseal, Licorice, St. John's wort, Kava, Valerian root.

    3. Cardiovascular Effects: Ephedra (tachycardia, hypertension, palpitations), Garlic (hypotension).

    4. Anesthetic effects: Valerian root, St. John's Wort, Kava.

    5. Other: St. John's Wort and Dong Quai (photosensitivity), Ginseng (hypoglycemia).

    Dr. Alan Gold, president of the American Society for Aesthetic Plastic Surgery (ASAPS), said that physicians must have at least basic knowledge of the common alternative medications and their side effects, and then be very involved and active in discussing the use of herbal supplements with their patients during the history, consultation and informed consent process. Quitting the use of certain herbal supplements before the operation is just as important as stopping the use of aspirin, ibuprofen and many other common drugs, he said.

    This article was written in order to help plastic surgeons and their patients identify potentially hazardous and harmful herbal supplements, based on the most current scientific evidence, said Dr. Rowe. On the positive side, the experts also discuss how providing the correct supplements and nutrients after aesthetic surgery can be very therapeutic.

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