DMSO pros and cons?

DMSO (Dimethyl Sulfoxide) is a wood product which has been around for a long time.  It has many properties valuable to plastic surgery patients.I was first introduced to DMSO in the early days of tissue expansion by Dr. Gordon Sasaki, originally 5th generation Hawaii but now from California.  Dr. Sasaki is one of the most brilliant plastic surgeons, and used DMSO to take away pain during the tissue expansion in women who had mastectomies.  One of its many properties is that it is both anti inflammatory and relaxes elastin fibers during tissue expansion, and therefore is very valuable both in reconstructive and cosmetic plastic surgery.  The world's expert on DMSO is Dr. Stanley Jacobs from the University of Oregon, and whose formula for DMSO I have used for over 20 years.  DMSO can be used pre-operatively to open choke vessels before a facelift, tummy tuck, breast lift and/or reduction.  Choke vessels is a term given to the redundant blood supply to all the tissues of the body.  The natural opening of these redundant blood supply is done when the blood stream is low on oxygen, i.e. when someone is being choked.  This increased blood supply brings oxygen to tissues for wound healing and it also brings white blood calls to tissues in an increased number to take away injured tissue and cells, decreasing swelling, bruising, and inflammation.   These same choke vessels can be opened by the chemical DMSO.DMSO is also a world renowned trans dermal, and therefore spraying it on the skin is just as effective as drinking it.  DMSO is used by neurosurgeons, orthopedic surgeons, and others who deal with inflammation and swelling.  The majority of the DMSO in the world is used by trainers and expensive horse owners because it is actually a horse liniment, but the raw DMSO that someone can get from a veterinarian warehouse needs to be modulated by using an emolliant such as Urea which decreases the irritation to human skin.  DMSO can be used post-operatively to decrease bruising and swelling.  It is also FDA approved in a specific treatment for interstitial cystisis.  The brand name for this drug is Rimsol-50.As far as a comparison between the value of DMSO vs. Arnica, I have never seen any scientific studies on the subject.  However, my personal anecdotal experience is that DMSO works faster and is generally more effective.  

Key factors in the healing of any wound are nutrition and vitamin supplements.  There are specially formulated vitamins that are designed to optimize your healing that we use from Vitamedica.  In addition, we use Arnica and Bromelain to reduce the swelling and bruising.  Before and after surgery, nutrition is a key component that is overlooked by almost every patient and surgeon.  After the operation, your calorie and protein requirements are increased.  We design a nutritional regimen for each patient which is provided to them during the preoperative teaching.  In order to meet the calorie and protein requirements after surgery, the patients typically supplement using protein shakes.  Calorie and protein intake are recorded on a log that we provide and review at the postoperative visits.  The combination of homeopathic medicines, vitamins supplementation, and adequate calorie and protein intake are critical to the wound healing process.  Prior to surgery, we ask the patients to stop all of their own supplements as some can cause problems with bleeding during and after surgery.

Cosmetic surgery performed in a precise, meticulous technique often leaves little to no bruising and minimizes the pain you may experience after surgery.  Pre-operatively avoiding any medications or supplements that "thin" the blood is also helpful in minimizing bruising after surgery.  It is important to inform your surgeon of all medications and supplements you are taking before surgery so they can tell you which ones should be stopped prior to your procedure. 

After surgery follow your surgeon's protocols for activity, diet, garments, etc. to optimize your recovery.

DMSO is a universal solvent that can carry almost any molecule through the skin. You can by it in a cream or gel form on Amazon or Ebay without FDA approval. There is a form that can be instilled by doctors or patients into the bladder and is FDA approved for cystitis. There is some support for its use as a carrier for other medications when applied topically for arthritis or complex regional pain syndrome. There is limited documentation of its use in cosmetic or reconstructive surgery. Its use for human single-stage intraoperative tissue expansion to enhance circulation was described in 1991. Although it may relieve pain and limit bruising it likely can improve survival of the skin after facelifts etc. A 2004 study of abdominal flaps raised in rats whose veins were clamped and then un-clamped showed improvement of flap survival from 7% to 18% with topical application of 50% DMSO. The exact dosing as it applies to humans though is not clear. Thank you for your question as it opened my eyes to new ways of treating patients.

I do not recommend DMSO or Arnica, though I am not opposed to patients using Arnica.Kenneth Hughes, MDLos Angeles, CA

Many plastic surgeons today utilize an electrocautery to perform a breast augmentation which allows for a clean dissection with minimal bleeding and thus, minimal to no bruising.  Early movement and anti-inflammatories such as ibuprofen will assist in achieving a rapid, comfortable recovery.