When the Daily Mail asked Dr. Frank Agullo about a viral garlic-and-honey “natural Botox” ritual, his answer went straight to surgery: “It has a mild blood-thinning effect through platelet inhibition. I ask patients to stop garlic supplements roughly two weeks before surgery for the same reason I ask them to stop fish oil and high-dose vitamin E.”
At Southwest Plastic Surgery that rule is delivered on the pre-op phone call, two to six weeks before surgery. Below is that call, in the pre-op nurse’s own words.
When do patients stop vitamins and supplements?
Our pre-op nurse: “You’re gonna stop all vitamins, supplements, pre-workouts, or anything that you take that is not prescribed. If you’re taking any prescribed medications, you continue taking them.”
Two weeks before surgery. Everything non-prescription, not a checklist.
The reason for a blanket rule: the published hold list (from a preoperative review in Mayo Clinic Proceedings) runs garlic, ginkgo, ginseng, vitamin E, guarana, horse chestnut, policosanol, resveratrol, saw palmetto, turmeric and vanadium, plus high-dose fish oil. The American Society of Plastic Surgeons publicized a study in which 17.5 percent of patients would have been at bleeding risk had they not stopped their supplements. Nearly one in five.
What patients take instead
Our pre-op nurse: “Our vitamins are called Recovery Support. They help you with the bruising, the swelling, and everything that you need to heal, to have a smooth healing process. It’s a month treatment that you start 2 weeks before, then you finish it 2 weeks after.”
Our pre-op nurse: “One bottle labeled Morning Formula, the other bottle Evening Formula, the third bottle Bromelain. The morning and the evening formula, those are the only ones that you’re going to start. The morning formula is gonna be 3 before breakfast. The evening formula, 3 before dinner. Then you’re gonna continue with the Bromelain, which is gonna be 3 days before the surgery.”
Our pre-op nurse: “Bromelain is what pineapple contains, a natural antibacterial and a natural anti-inflammatory.”
The arnica
Our pre-op nurse: “That box is actually opened and taped because I labeled every tablet for you. You’re gonna start with the first tablet that is labeled pre-op, 24 hours before the surgery. Then you’re gonna continue with the post-op, that is gonna be 4 hours after surgery. And then at bedtime the day of the surgery. You’re gonna continue with day 2, morning, afternoon, evening. Day 3, day 4, and you’re done. The arnica pills is only a 4-day treatment.”
Dr. Agullo: “Arnica and bromelain help with bruising.”
GLP-1s
Our pre-op nurse: “I’m gonna need for you to stop taking it 2 weeks before the surgery and 2 weeks after. The reason why, they slow down your intestinal motility, as well as the surgery, and we do need for you to have bowel movements right after surgery.”
Iron for liposuction and tummy tuck patients
Prescribed, so it stays. It starts two weeks ahead for anyone having liposuction or a tummy tuck.
Our pre-op nurse: “The reason why, we do lose a little bit of blood during surgery. So if you lose a little bit of blood and it’s high, it’ll go to normal levels other than having it normal and dropping to anemia.”
Our pre-op nurse (translated from Spanish): “We prescribe ferrous gluconate, and usually when you buy over the counter it is ferrous sulfate, and the sulfate causes a little constipation, the gluconate does not, and the gluconate has better absorption.”
Speeding up recovery
Dr. Agullo: “We do have something called ElixirMD, which, if you can come every day for five days, it’s an LED treatment, and it speeds up the recovery by, like, twice as fast.”
Dr. Agullo: “NAD infusions with glutathione before and after surgery help clear the anesthesia. Post-op peptides, GLOW for face work and GLOK for body, help with inflammation and tissue regeneration.”
Natural is not the same as harmless
Dr. Agullo to the Daily Mail: “One clove in food is not a crisis, but a patient who has escalated to several cloves a day plus a supplement is a patient I want to know about.”
Nicotine is handled under a separate rule, for healing rather than bleeding; Dr. Agullo covers it in its own post. The full first-person version of this post is on agulloplasticsurgery.com.
What the practice needs from you
A complete, honest list of everything you take, prescription and over the counter, at the pre-op call. A photo of the cabinet works.
Schedule a Consultation
To plan surgery at Southwest Plastic Surgery, or to ask the pre-op team about the supplement rule and the recovery protocol, call (915) 590-7900 or text 1-866-814-0038. #StayBeautiful
