Elective aesthetic surgery patients are very likely to use dietary and herbal supplements—often without telling their surgeon. That matters because certain products can increase bleeding, change anesthesia effects, cause photosensitivity, or delay wound healing. When it comes to safety, knowing which homeopathic & herbal medications to stop before surgery is crucial. This guide explains what to stop, when to stop it, and why—so you can have the safest, smoothest recovery.
Fast rule of thumb: If you’re unsure about any supplement, stop it 14 days (2 weeks) before surgery and bring the bottle(s) to your pre‑op visit.
Why surgeons ask you to stop supplements
- Large U.S. surveys show supplement users are commonly the same population that seeks elective aesthetic surgery.
- In surgical clinics, 40%+ of patients report taking herbs that can affect bleeding or blood pressure, and ~25% use products known to interact with prescription medications. Many patients don’t report them because they’re “natural.”
Bottom line: “Natural” doesn’t mean “risk‑free,” especially around anesthesia and surgery.
What to Stop Before Surgery (and When)
Standard recommendation unless otherwise noted: Stop 2 weeks before surgery.
| Supplement | What it’s used for | Key concerns around surgery | When to stop |
|---|---|---|---|
| Arnica (Arnica montana) | Bruising, soreness (often topical; also homeopathic oral) | Topical generally well‑tolerated; non‑homeopathic oral forms can be toxic (cardiotoxicity, severe hypertension). Do not apply to broken skin. | Usually provided for facial cosmetic surgery (homeopathic oral safety depends on dilution; avoid DIY use; topical OK on intact skin until day before unless told otherwise). |
| Bromelain | Anti‑inflammatory from pineapple; swelling | Theoretical bleeding risk; may raise antibiotic levels (e.g., amoxicillin, tetracycline); may raise heart rate at high dose. | Usually provided for facial cosmetic surgery if you have any bleeding disorder, liver disease, or take anticoagulants. Otherwise, discuss at pre‑op. |
| Dong quai (Angelica sinensis) | “Female ginseng,” hormonal balance | Anticoagulant effects (prolonged PT/aPTT); photosensitivity; GI side effects; sugar content in some preparations. | Stop 2 weeks prior. |
| Echinacea | Colds/URIs | Drug interactions (CYP3A4), possible immunosuppression with long‑term use (>8 weeks), theoretical infection/wound‑healing concerns. | Stop 2 weeks prior. Contraindicated in immune disorders—tell your surgeon. |
| Goldenseal | Antimicrobial claims | CYP3A4 inhibition (drug interactions), photosensitivity, electrolyte effects. | Stop 2 weeks prior. Avoid UV/laser exposure near treatment. |
| Grape seed extract | Antioxidant, anti‑inflammatory claims | In‑vitro antiplatelet effects → prudent to hold pre‑op. | Stop 2 weeks prior. |
| Licorice (Glycyrrhiza glabra) | Anti‑inflammatory, GI | Hypertension, arrhythmia, hypernatremia, hypokalemia; CYP3A4 interactions; contact dermatitis (topical). | Stop 2 weeks prior. |
| St. John’s wort | Mood/anxiety | Major drug interactions (induces CYP P450), photosensitivity, risk of prolonged sedation and serotonin syndrome with certain meds; can alter metabolism of midazolam, lidocaine. | Stop 2 weeks prior. |
| Vitamin E | Antioxidant | Alters platelet function; may inhibit collagen synthesis and delay healing; bleeding concerns. | Stop 2–3 weeks prior. |
| “Five G’s” (Garlic, Ginger, Ginkgo, Ginseng, Grape seed) | Various wellness claims | Bleeding risk (strongest clinical link for Garlic); others have varying levels of evidence from case series to lab data. | Stop 2 weeks prior. |
| Kava kava | Anxiety/sleep | Platelet dysfunction (in‑vitro); sedation/anesthesia concerns. | Stop 2 weeks prior. |
Photosensitizers to flag: Dong quai, Goldenseal, St. John’s wort, and retinoids (vitamin A derivatives). Tell us if you’re planning laser or light‑based treatments.
What’s Usually Safe to Continue
| Vitamin | Role in healing | Pre‑op guidance |
| Vitamin A | Supports collagen and counteracts steroid‑related healing impairment | Continue typical dietary doses; high‑dose or therapeutic use should be supervised by your provider. |
| Vitamin B12 | Nerve and blood health | Generally no need to stop; rare rash/itching. |
| Vitamin C | Essential for collagen synthesis and cross‑linking | Often continued; many protocols use 1,000–2,000 mg/day—confirm your dosing with our team. |
| Omega‑3 fatty acids | Heart/brain health | Contrary to popular belief, good evidence does not show increased surgical bleeding at routine doses; we’ll individualize based on your meds and procedure. |
Important: Even with “safe” vitamins, bring your exact products and doses to your pre‑op visit for a personalized plan.
Frequently Asked Questions
Do I have to stop all supplements before surgery?
Not necessarily. We focus on products with bleeding risk, major drug interactions, photosensitivity, or potential wound‑healing issues. When in doubt, pause for 14 days and ask us.
Is homeopathic arnica safe before plastic surgery?
Topical arnica on intact skin is generally well‑tolerated. Oral arnica is only considered safe at homeopathic dilutions under guidance; non‑homeopathic doses can be dangerous. We recommend not starting any arnica on your own and stopping unsupervised use 2 weeks pre‑op. We provide our own formulation that is beneficial to prevent bruising for facial cosmetic surgery.
Can bromelain help swelling after surgery?
Some studies show reduced postoperative facial swelling, but dosing varies widely and products aren’t standardized. We provide a formulation in our office that offers this benefit.
What if I forgot and took supplements within 2 weeks of surgery?
Tell us immediately. We’ll weigh your exact product, dose, and procedure. Sometimes we proceed with adjustments; other times we reschedule for safety.
I’m having laser or light‑based treatments—what should I stop?
Avoid photosensitizing supplements: St. John’s wort, goldenseal, dong quai (and retinoids). Stop 2 weeks prior and use strict sun protection.
References
Dietary Supplements and Current Available Evidence. Xue, Amy S. M.D.; Dayan, Erez M.D.; Rohrich, Rod J. M.D. Plastic and Reconstructive Surgery 146(4):p 474e-481e, October 2020.
American Society of Plastic Surgeons. Top_10_List_of_Herbal_and_Supplemental_Medicines