Whenever someone MUST have emergency surgery to save life or limb, he will be whisked to the OR despite risk factors because the cosequences of delay could be deadly. That is NOT the case with elective (IE you and your doctor CHOOSE WHEN to to have your) surgery and especially with Cosmetic surgery in which you choose to have a surgery to improve your appearance at a time of your choosing. With cosmetic surgery, we try as much as possible to pick up and minimize risk factors. Increased bleeding can be caused by certain herbs additivies including Vitamin E (the reason why we ask people to stop taking multivitamins) and medications such as Aspirin,Advil, Alleve etc. Many diet pills contain additives which make your heart race (IE Ephedrine) or interact with anesthesia. Phentermine has been known to drop your blood pressure during surgery and many of my anesthesia colleagues prefer you were not on it. (See official statement below) Personally, rather than worry about which ingredeient is in each one of your bottles, I think it it would be far safer for you to stop taking all such additives and unnecessary medications before surgery. Dr. P. Aldea Media Statement of the American Society of AnesthesiologistsRegarding Phentermine (Phen) The American Society of Anesthesiologists (ASA) is aware of and concerned about reports that some patients taking the diet drug nicknamed "Phen" and not disclosing this to their anesthesiologists prior to surgery, are experiencing adverse and potentially deadly reactions while under general anesthesia. Phen is actually a potent drugs, phenterimine, that can alter the chemical balance in the brain's two neurotransmitters, serotonin and dopamine. The proper balance of these two chemicals in the brain is critical. Monitoring the patient's vita' signs is one of the important functions that anesthesiologists do during surgery, and several ASA members recoil that some patients who were taking phentermine have become hypotensive (with abnormally low blood pressure) while under general anesthesia. Left unattended, this hypotension may become dangerous and life threatening. The "Basic Standards for Preanesthesia Cart" approved by the ASA House of Delegates in 1987 states that an anesthesiologist must develop an appropriate plan of anesthesia care that is based in part on a patient's medical history and drug therapy, including medications. For this reason, it is imperative that patients be forthcoming when they talk to their anesthesiologist about any drugs they have taken prior to surgery. This includes all prescription and over-the-counter medications such as diet pins, vitamins, and herbal preparations. Source: Norig Ellison, MD, President, American Society of Anesthesiologist; October 1906, Copyright ? 1996 American Society of Anesthesiologists. AU rights reserved. Used with permission.