PEER-REVIEWED PUBLISHED RESEARCH ON THE USE OF SUPPLEMENTS POST-OP

 

Below are links to peer-reviewed published research articles on the suggested supplements so you can discuss them with your surgeon.

 

BROMELAIN:

• “Effect of Oral Bromelain on Wound Healing, Pain, and Bleeding at Donor Site Following Free Gingival Grafting: A Clinical Trial” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397736/
• “Potential role of bromelain in clinical and therapeutic applications” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998156/

 

VITAMIN C: 

Helps reduce post-op pain and increase collagen building to speed tissue repair):  

• “Efficacy of Vitamin C Supplementation on Collagen Synthesis and Oxidative Stress After Musculoskeletal Injuries: A Systematic Review”  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204628
• “The Effect of Perioperative Vitamin C on Postoperative Analgesic Consumption: A Meta-Analysis of Randomized Controlled Trials” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600013/

 

ZINC: 

• “Zinc in Wound Healing Modulation”  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793244/

 

PROBIOTICS: 

• “Efficacy of Using Probiotics with Antagonistic Activity against Pathogens of Wound Infections: An Integrative Review of Literature”  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6930797/
• “Probiotics for the prevention and treatment of antibiotic-associated diarrhea” https://pubmed.ncbi.nlm.nih.gov/22570464/
• “Effects of probiotics on the composition of the intestinal microbiota following antibiotic therapy” https://www.sciencedirect.com/science/article/abs/pii/S0924857905001172

 

VITAMIN D3: 

“Low vitamin D levels linked to increased risks after non-cardiac surgery” https://www.sciencedaily.com/releases/2014/08/140815102033.htm 

“Vitamin D status and surgical outcomes: a systematic review” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413543/ 

 

AMINO ACIDS: 

• “Pre- and Post-Surgical Nutrition for Preservation of Muscle Mass, Strength, and Functionality Following Orthopedic Surgery” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8156786/ 
• “Enhanced Recovery after Abdominoplasty Using Perisurgical Nutritional Supplementation”   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787335/ 

 

MAGNESIUM CITRATE:

Helps with post-op pain and constipation caused by anesthesia.

• “Systemic magnesium to improve quality of post-surgical recovery” https://pubmed.ncbi.nlm.nih.gov/24491463/ 

 

Help with wound healing and new blood vessel growth .

• “Oral administration of marine collagen peptides from Chum Salmon skin enhances cutaneous wound healing and angiogenesis” https://onlinelibrary.wiley.com/doi/abs/10.1002/jsfa.4435 

  

 

One of several proteolytic (protein-breaking) enzymes that is believed to help with fibrosis and scar tissue formation. Much anecdotal evidence (observations) exists among practitioners who believe in the efficacy of serrapeptase, but research has not been conducted to study its actual efficacy at this time. While it may be helpful, please be aware that there are precautions such as waiting about two weeks post-op before beginning therapy as it could possibly lead to bleeding. The 2-week delay is so that the body has time to make repairs strong enough to withstand an enzyme that breaks down protein. That being said, if someone is beginning to form fibrosis after week 2 post-op, it may be of use to help break down the excessive protein that causes those hard lumps to form.

CAUTIONS!: Serrapeptase should NEVER be taken together with anything that thins the blood, such as aspirin or warfarin. It should NEVER be taken if infection is suspected as it could cause it to spread. – https://www.verywellhealth.com/serrapeptase-89513 

 

What Is Serrapeptase? The silkworm enzyme is believed to reduce pain and inflammation.  “Role of Serratiopeptidase After Surgical Removal of Impacted Molar: A Systematic Review and Meta-analysis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878179/

 

 

NATTOKINASE: 

An enzyme produced by the bacterium Bacillus subtilis during soybean fermentation Nattokinase is one type of proteolytic enzyme (breaks down protein) that has been touted for the resolution of fibrosis and blood clots. Due to reports of hemorrhage (uncontrolled bleeding) after using this enzyme, using it in the immediate weeks post-op is likely not advisable as its action is quite strong. Additionally, it tends to lower blood pressure which could create even more of a fainting risk in the first few weeks post-op. –  

“Nattokinase: A Promising Alternative in Prevention and Treatment of Cardiovascular Diseases”  https://journals.sagepub.com/doi/10.1177/1177271918785130

 

 

CAUTIONS ABOUT COMMONLY RECOMMENDED REMEDIES POST-OP

WHY YOU SHOULD NOT TAKE ARNICA BY MOUTH IN TEA, TABLET, OR OTHER FORM:

 

A question I often get asked is “Why don’t you recommend taking arnica for bruising?” While arnica applied to the skin (topical) is more or less considered safe, taking arnica by mouth (ingested) is not. It is a toxic compound. Due to the lack of regulations in homeopathic or tea-based preparations, dosages can be all over the board. Symptoms of arnica poisoning include abdominal cramping, diarrhea, nausea, and vomiting. Despite this, many plastic surgeons unknowingly recommend these products to their patients. A safer bet for resolving bruising quicker is bromelain. https://www.latimes.com/health/la-he-0301-in-practice-20100301-story.html – “Well, the plastic surgeon recommended arnica”

 

 

WHY YOU SHOULD NOT USE PINEAPPLE JUICE, FRESH FRUIT, OR PINEAPPLE TEA:

 

Pineapple juice, fresh pineapple, and pineapple teas are commonly recommended across the internet as a remedy for bruising post-op. However, these are generally ineffective when compared to bromelain tablets (the compound in pineapple that helps with bruising.) This is true for several reasons. 

 

First, most of the bromelain in pineapple is found in the core/stem – the part we throw away (see here for details on bromelain concentrations in different parts of the pineapple: https://www.sciencedirect.com/topics/agricultural-and-biologicalsciences/bromelain). What this means is that eating pineapple does not provide sufficient therapeutic levels of bromelain. 

 

Second, pineapples are full of SUGAR which is one of the things you want to avoid after surgery because it increases inflammation. Third, regarding making the ever-popular “pineapple tea” seen on numerous social media locations, bromelain is not very heat resistant. It breaks down at only 160 degrees Fahrenheit (71 degrees Celsius), but if brewed for 30 minutes only requires 140 degrees Fahrenheit (60 degrees Celsius) to destroy it. Boiling water is 212 degrees Fahrenheit (100 degrees Celsius), which means that most tea preparations contain absolutely no bromelain at all.

 

 

SUPPLEMENTS TO AVOID POST-OP

 

The following is a list of herbs, vitamins, and medications that can interfere with plastic surgery There are many common supplements and medicines that we buy over the counter, and believe that they are harmless because they are easy to obtain (like aspirin) or because they are a natural substance. Many of these things can interfere with your surgery by making it hard to clot (a necessary process to stop bleeding) or they have other undesirable effects.

• Vitamin E
• Chromium
• Garlic
• Ginger
• Ginkgo
• Goldenseal
• Ginseng
• Feverfew
• Flaxseed
• Fish oil
• Echinacea
• Licorice
• Saw Palmetto
• Ephedra
• Kava-Kava
• St. John’s Wort
• Valerian Root
• Appetite Suppressants (including herbal ones)
• Pain killers that are also blood thinners such as aspirin, Motrin, Advil