Explore Plastic Surgery - Dr. Barry Eppley

Prevention of complications after plastic surgery, such as bleeding and slow wound healing, can be aided by proper management of a variety of common medications. As an Indianapolis plastic surgeon, this is the medication to-do-list (and not-to-do) that I provide to each of my patients prior to their surgery.

Medications to avoid two weeks prior to surgery:

Discontinue use of any nicotine products. This includes cigarettes, cigars, nicotine gum, and patches. Nicotine reduces the blood flow to the skin and may impair healing; and quitting smoking drastically improves the body’s response to surgery.

Stop using medications containing aspirin and NSAIDS (non-steroidal anti-inflammatory medications, such as ibuprofen, Alleve, Advil) prior to (and following) surgery. Aspirin and NSAIDS thins the blood and can produce excess bleeding and bruising. Be sure to read the labels of any over the counter remedies you regularly take as many commonly-used medications contain aspirin. (e.g., Alka Seltzer) For the same reason, also avoid Vitamin E supplements and red wine prior to surgery.

Stop all herbal medications before surgery. The most common herbs used 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.

Medications to start two weeks prior to surgery:

Begin using an Arnica supplement 7 days prior to surgery and continue for two weeks following surgery. Arnica is a naturopathic remedy that not only helps prevent bruising but also aids in clearing bruising that has occurred faster after surgery. We have both orally-taken Arnica tablets and topical Arnica patches and gel tubes available at my OLOGY Spas for this purpose.

Begin a good multivitamin supplement at least two weeks or more ideally one month, prior to surgery. A normal dose of vitamins and minerals combined with a diet high in protein provides the necessary building blocks for wound healing.

Begin high dose Vitamin C supplements. (2 grams per day) both before and after surgery. This well known vitamin is the key nutrient needed for making collagen after surgery, which is what heals your tissues together. Because Vitamin C is water-soluble, there is no risk of overdosing on it. What is not used by your body will be excreted in your urine.

You might also consider adding Vitamin K to your diet. This fat-soluble vitamin plays an important role in blood clotting and can be found in spinach, broccoli, and kiwi.

Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Arnica has been used for years both as a topical ointment and as an oral supplement. Applied externally, it reduces bruising and muscle soreness. When taken orally, it helps reduce/clear bruising and speed healing after surgery or a traumatic injury. While arnica has been used for over 100 years, it has caught a lot of attention in the past decade as more recent studies have shown its benefits as a more proven certainty.
Arnica Montana is a mountain flower that grows around the world. Its healing properties have been credited to many of the over 100 components which are found in the plant. Arnica contains a class of chemicals known as sesquiterpene lactones which have anti-inflammatory benefits. Arnica also contains antioxidant flavonoids, cartinoids, and silicic acid which all are also believed to have healing actions.
In plastic surgery, less swelling and bruising was seen after rhinoplasty in patients who took oral arnica versus steroids in a published study in July 2007 of Plastic and Reconstructive Surgery. Other positive findings have been seen in facelift surgery where less bruising was observed with its use. I routinuely precribe it as a pre- and postoperative medication (one week before and after surgery) for my cosmetic surgery patients. Both patients and I have become convinced of ts beneficial properties, particularly in the more rapid resolution of bruising. As a topical ointment, I use it on facial plastic surgery patients as an adjunct to oral arnica to have the best effect on clearing bruising.
Dr Barry Eppley
http://www.eppleyplasticsurgery.com
http://www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis

Reduce Bruising after Surgery!

Used for centuries in Europe to treat swelling, soreness, and bruising, Arnica Montana (extract of the dried root and flower of the arnica plant and also known as leopard’s bane) can be used either by tablet or applied as a topical gel. I particularly like its oral form and have all of my Indianapolis plastic surgery patients take it sublingually (under the tongue) starting one week before and then one week after surgery as well. Patients should take 4 tablets under the tongue four times a day. The pills are very small and have no real taste to them so they are not unpleasant to take.

This homeopathic remedy is believed to have anti-inflammatory and antibacterial properties and stimulates white blood cells to aid healing by eliminating excess fluid from the surgical area. To me, the more impressive property is its effect on decreasing bruising. Having used it in patients for years, there is no question that it decreases the amount of bruising that occurs after surgery as well as helps clear bruising that does occur faster. My patients frequently comment on how effective it has been for them. I have no hard scientific evidence that quantifies exactly how much it prevents bruising or how much better it clears bruising but my feeling is about 25 – 33% prevention and about 50% prevention.

Arnica is of particular value in all facial plastic surgery such as rhinoplasty, blepharoplasty, and facelifts as well as liposuction body surgery. It is very inexpensive (less than $40 for 100 tablets) and has no real side effects so there is no reason not for the patient to take it. We keep a stock in the office so patients have easy access to it.

Dr Barry Eppley
www.eppleyplasticsurgery.com
www.ologyspa.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis