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    Nearly 1 of out 4 Americans takes some kind of herbal supplement. The majority of cosmetic surgery patients do not disclose that they take these over-the-counter supplements, most commonly because they don’t really consider these to be medications. While the health benefits of vitamins and other supplements can be tremendous, there can be unforeseen side effects of taking these medications. A variety of herbs, vitamins, and over-the-counter supplements have the potential to cause serious problems during your surgery and afterwards. 

    Different herbal supplements have different effects on your body. Some cause excessive bleeding while others interfere with anesthesia or other medications you may need. Dr. Jejurikar stresses the importance of reporting your usage of all vitamins and herbal supplements that you take prior to cosmetic surgery and reconstructive plastic surgery. 

    The American Society of Anesthesiologists recommends that all patients stop taking herbal supplements at least two weeks before surgery, no matter the operation. They stress that, just because a medication is “natural” does not mean it is safe during surgery.

    Dr. Jejurikar tells his patients that many herbal supplements, including aspirin, Vitamin E, St. John’s wort, ginkgo biloba, garlic, ginger, ginseng, and feverfew an cause increased bleeding during surgery. This increases the risk of blood loss, can increase postoperative bruising and swelling, and in the worst cases, can cause a hematoma, which is a collection of blood which may need to drained surgically.

    A few of these supplements, such as ginseng are found in popular energy drinks and herbal teas. Because of this, Dr. Jejurikar recommends to his patients that they stop these 2 weeks prior to surgery as well.

    Herbal supplements and vitamins to avoid prior to surgery include (in alphabetical order):

    • BROMELAIN – Take only after consulting with Dr. Jejurikar. Can be beneficial with postoperative bruising, but may cause postoperative bleeding 
    • DANSHEN – May cause bleeding
    • DONG QUAI – May cause bleeding
    • ECHINACEA – May interfere with immune functioning, which can affect healing
    • EPHEDRA – May cause abnormal heartbeat, extreme high blood pressure and coma if combined with certain antidepressants and anesthesia
    • EPHEDRINE comes from ephedra, also called ma huang, which has been implicated in heart attacks and strokes. It also causes the blood pressure to rise, and can cause bleeding 
    • FEVERFEW – May cause bleeding
    • GARLIC – May cause bleeding, may interfere with normal blood clotting
    • GINGER – May cause bleeding
    • GINKGO BILOBA — May cause bleeding
    • GINSENG – May cause bleeding, rapid heartbeat, hypertension
    • GOLDENSEAL – May cause or worsen swelling and hypertension
    • LICORICE (not including candy) – May cause postoperative hypertension
    • OMEGA-3 FATTY ACIDS – May cause bleeding if taken in doses greater than 3 grams a day
    • SENNA – May cause electrolyte imbalance
    • ST. JOHN’S WORT May diminish or enhance the effects of some drugs used during and after surgery
    • VALERIAN — May prolong the effects of anesthesia
    • VITAMIN E — Taking greater than 400 unites per day can result in increased postoperative bleeding

    If you questions, or would like to schedule a consultation, call Dr. Sam Jejurikar’s Dallas or Plano office at 214-827-2814.


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    9101 N. Central Expwy.
    Suite 600, Dallas, TX 75231
    Tel: 214.827.2814
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