Arnica Pellets for Ethnic Rhinoplasty to reduce swelling?

I will be taking Arnica Pellets to help with bruising and swelling for my ethnic rhinoplasty procedure. My question is, do I start taking the arnica before, on the day of, or after the procedure? If I start taking the Arnica pellets before the procedure; how many days prior? Also how many days after the procedure can you continue to take the Arnica pellets as well as the arnica gel? Should Bromelain be used as well? Thanks

Doctor Answers 4

Postoperative instructions after rhinoplasty

With regards to minimizing bruising and edema (swelling), I would recommend the following:1. Avoid Aspirin, Advil, Motrin, Ibuprofen, all other NSAIDs, Coumadin, Plavix, vitamin E, fish oil, omega-3, herbal supplements and vitamins, etc.for 2 weeks
before and after the surgery. (If you take blood thinners, make sure you speak to
your doctor about discontinuing these medications!)2. Adhere to a low sodium diet (less than 250mg per meal) for 4-6 weeks after surgery!

3. You may eat fresh pineapple and/or take Bromelain 3 days
before and 1 week after surgery. 

4. No strenuous activities that increase your heart rate, blood pressure, or cause perspiration for 4-6 weeks after surgery.

5. Sleep with your head elevated.6. Most importantly, follow the instructions of your surgeon, especially if they differ from these recommendations!Best wishes!

Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Arnica for Rhinoplasty

In our practice, we perform a lot of rhinoplasties and have found Arnica and Bromelain to be very helpful during the immediate postoperative period allowing many patients to recover quickly.  We recommend taking it the night before surgery and then continue for 5 days after.  The reason for the multiple different answers you will get on this forum is because Arnica isn't regulated in the US so there are several different manufacturers.  I would follow the instructions on your bottle /box and ask your doctor's office what has worked for them on their patients.  If your doctor's office has one they like, its probably because it has worked well for their patients and I would use that instead of an over the counter version.  Good Luck!!

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews

Ethnic rhinoplasty

The reason we do not use arnica/ bromelaine in our practice, is because it is way too complicated for  patients and they get confused, as demonstrated in your questions. Ethnic rhinoplasty is already difficult enough with  the medications to be taken afterwards which include antibiotics, anti-nausea pills and pain medications. In addition, when thick skin is present in the ethnic nose, this will acquire steroid shots  in the postoperative period. It is best to check with  your operative surgeon to see if they recommend  taking anything additional

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Use of Arnica and Bromelain

Thank you for your question.  Some studies show a beneficial effect using Arnica and Bromelain.  Other studies show there is no effect.  In my opinion, Arnica and Bromelain should be started the day after surgery to minimize the risk of bleeding.  I have tried Arnica and Bromelain before surgery and have noted significant more bleeding from the surgical site. Therefore my recommendation is to start Arnica and Bromelain the day after surgery.  For facial and eyelid surgery, I recommend elevating the head for four days and using saline soaked 4 by 4s every 30 minutes while you are awake for four days.  Remember, peak swelling after surgery is on the third day.  Therefore, I have my patients ice one day beyond this and I have found it to be very beneficial. I hope you find this helpful. Best wishes in your upcoming surgery!


James Fernau, MD, FACS

Board Certified ENT

Board Certified Plastic Surgeon

Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 64 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.