Under the Knife
Plastic surgery patients are more likely than other people to use supplements, but not telling their doctors about herbal remedies could put them at risk when they undergo cosmetic procedures. Glucosamine, echinacea and ginseng -- three of the most popular supplements among cosmetic patients -- can trigger bleeding, prolong sedation and suppress natural immunity during and shortly after surgery, warn plastic surgeons at the University of California, Los Angeles, in the February issue of the journal Plastic and Reconstructive Surgery.
Don't Ask, Don't Tell James P. Bradley and his colleagues surveyed 100 cosmetic surgery patients in their mid-forties and compared them with 100 Los Angeles residents. Bradley's team found that 55 percent of the patients said they took at least one supplement regularly, compared with 24 percent of the control group.
Although Bradley did not determine how many plastic surgery patients informed their doctors of supplement use, previous studies have found that 70 percent of patients don't tell their doctors they are taking herbal medicines. In some cases, that's because patients don't consider them to be drugs; frequently the doctor never asked.
That underscores another of Bradley's findings. The team surveyed 20 board-certified plastic surgeons around the country and found that none knew the side effects of nine of the 10 most commonly used supplements.
When to Stop In 2004 the American Society of Anesthesiologists recommended that most supplements be stopped at least two weeks before elective surgery to prevent complications. Because supplements are popular among plastic surgery patients, Bradley concluded, surgeons have an obligation to understand their side effects and to treat them like other drugs.
--Sandra G. Boodman