When and how much arnica and bromelain should I use before a facelift with fat grafting?

Thank you for your question!  Arnica Montana is a homeopathic remedy which is commonly used to help with bruising after injections and surgery.  We use this quite often, and most of our patient, and most tell me that they see a difference.  As far as recommendations for your surgery, I would speak with your surgeon as to how much he/she would like you to take beforehand.  I typically will recommend Arnica and Vitamin C, 2 weeks before and after surgery.  I do not routinely use bromelain, although I know that many use this with good success.I hope that this helps!-David Gilpin

Great question...homeopathic medications like Arnica, Bromelain, and Ledum are all understudied in the medical literature for sure.  Studies that are out there are conflicting, but you need to understand a little about homeopathy to gain a grasp on this topic.  One of the tenants of homeopathy is that of the "paradoxic" effect -- in other words, the homeopathic medication treats the condition that it causes.  In the case of Arnica, it can cause bleeding and that is why it treats bruising.  It's contradictory, but that is homeopathy.  For this reason, I have my patients avoid Arnica BEFORE surgery.  Only after surgery do I use these medications.  Now, the medical literature surrounding oral Arnica and Bromelain are the weakest -- for this reason, I do not even recommend the oral form any longer.  It won't hurt, but it likely won't do anything either.  I do recommend topical formulations, and the best topical formulation I have found is the Ocumend pad, which contains Arnica and Ledum and infuses into the skin.  The concentration of the medications in these pads are about 50x stronger than that of the gel you can buy over the counter.  I have performed a split face study on patients using the Ocumend pad on one side of the face following eyelid surgery and using a standard gel on the opposite and found a statistically significant difference in the amount of post-operative bruising.  It is pending publication currently.  You're going to find many different answers in this forum, so it's best to just follow the practices of your treating provider.  

Patients with questions and concerns about peri-operative oral suplementation with bromelain and or arnica should ask their surgeon about this matter. 

You should check with your surgeon about this. I have my patients take it before and after surgery as part of their VitaMedica Surgery supplements. Good luck.

Hello,Thanks for your question. You can usually purchase arnica and bromelain in preset dosing. Most patients take 4 sublingual arnica tablets three times daily. They take bromelain just once a day as directed. Pineapple juice has bromelain so it is a great option if you want to limit the number of pills you have to take. I have been using this combination in my facial plastic surgery practice for the last 10 years. The evidence of efficacy is anecdotal but patient experience has been overwhelmingly positive in my hands. Good luck,Dr. Shah

Thank you for your question.I think it depends on the doctor and what they prefer. I have information on Arnica in our pre-operative packet, but I do not think it makes a significant enough difference to make it mandatory. The big thing is avoiding medications prior to surgery that thin your blood, because that increases the bruising and swelling after surgery.

It is best to consult with your surgeon and their recommendations.
I advise my patients to commence taking Bromelain 2 weeks prior to surgery and to continue to take it 2 weeks after surgery.  It is not required to take. Bromelain is a pineapple extract that helps minimize bruising and speeds the recovery.

Answer: Hi, and thank you for your question. It is surgeon’s preference as to whether they advise a patient takes these supplements prior to a procedure. I would suggest that you phone your surgeon and ask for his/her advice regarding if/when to take them, as some supplements may not be suitable in advance of an operation. Wishing you the very best for your surgery!   

It is best to discuss with your surgeon.I give my patients the dosage I recommend complimentary in a post operative box as I believe there are many natural substances that help healing that traditional medicine has not yet embraced.  

Not all surgeons routinely use these drugs with a facelift. When used the recommended dosage is to take Arnica 30 tablets 3 days prior to surgery and for a week following surgery. Bromelain should be used for the same time period.