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

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

Arnica Montana is a homeopathic drug that is claimed to reduce bruising and swelling. Anecdotally, many patients and plastic surgeons feel that Arnica does have a benefit. There are, however, conflicting reports in the valid scientific literature about these claims. Bromelin (Bromelain), another homeopathic medication, is a mixture of enzymes found naturally in the juice and stems of pineapples and also purported to reduce swelling, bruising, inflammation and pain after surgery. This supplement, which is often taken along with Arnica, is also controversial with regard to efficacy.

I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS). You should discuss your concerns with that surgeon in person. It is critical that he or she should be aware of all medications, supplements, minerals, vitamins, and herbs that you are taking, because they may interfere with normal blood coagulation, healing, and anesthesia.

Robert Singer, MD  FACS

La Jolla, California