Cosmetic Botox and herbal supplements

The only risk of taking herbal supplements is that you can increase your risk of bruising and swelling.  It does not however effect the treatment outcome.

Thank you for the question. You ask if you can continue to take daily supplements such as cod liver oil, chlorella, spirulina and wheatgrass if you’re considering injections like Botox™ and Juvederm.

I can certainly give you my perspective on this. I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. I specialize in, among many things, in facial aging and injectables such as Botox™ and Juvederm which I’ve used for years in my practice every day. When you ask a question like this, it’s helpful for you to understand a little of what the doctor is thinking when it comes to various types of supplements, medications, and medical conditions you currently may have.



When we do injectable treatments, we want to minimize certain risks such as avoiding infection and minimizing bleeding. The reality with most injectables is when you are entering the skin with a needle, you can get a little bruise so it is generally advised to avoid aspirin and motrin or non-steroidal anti-inflammatories. Something like cod liver oil falls in the omega 3 fatty acid family, which is considered a mild blood thinner. However it is not necessarily, in my experience, a very strong blood thinner at least in terms of injectables. When we do more invasive procedures such as face lifting surgery or eyelid surgery, I generally advise people to stop taking their fish oil or other omega 3s like cod liver oil for at least 1 week prior to surgery.



The challenge for you is to  understand what kind of Botox™ and Juvederm injectable procedures you need, and figure out how it fits with the risks I just described, mostly with potential bruising. Often, doctors are judged by whether or not they create a bruise. There is some control in the doctors part where they use different methods such as tiny needles and  blunt cannulas to minimize bruising. However, the minute you enter the skin, you risk hitting a small vessel and create a small bruise. To minimize those risks, people often stay off blood thinners. Often, patients don’t often know something is a blood thinner and often have a Botox™ injection, or Juvederm, or any filler in an urgent manner because of a special event happening in a couple of days. There are a couple of ways to make an impact to minimize the risk of bruising. If someone like yourself came into my practice and told me they were taking these supplements, I really wouldn’t have any issues from a bruising risk factor.



As for the effect on the injectables themselves, I also think it isn’t really important. Botox™ is considered a neurotoxin that interrupts a signal between a nerve and a muscle. For example, if you inject Botox™ around the crow’s feet lines, you reduce the activity of that muscle. That is in contrast to Juvederm which is hyaluronic acid filler that adds volume. You can place this filler anywhere from the nasolabial folds, the cheeks,and jawlines. It is a different issue, but it’s not likely to be a problem.

It is very important that once you met with a doctor you feel comfortable with and establish a rapport, you get that specific doctor’s personal perceptions of the supplements you take, as well as other medical issues or medications you may have. Every doctor practices in a way they’re comfortable with, and will always have good reasons to make recommendations on what they prefer to take or not take before a procedure - that is the art of clinical practice. Meet with a qualified and experienced doctor who does Botox™ and Juvederm, and see if you are comfortable with what they recommend, then move forward. I think you’ll find as you start doing these treatments, you will learn a little about what is ideal for you so you can plan them the best way you can.I hope that was helpful, I wish you the best of luck and thank you for your question.

Supplements pose great frustration to physicians because they are not FDA regulated meaning that the strength of what is in those pills and liquids is anyone's guess.  Fish oil has been implicated in bruising. I would recommend abstaining from these tablets for two weeks before and at least a week after any procedure.