Does arnica and bromelain really help with bruising and swelling after facelift?

Question

What strength and what brands is the best? And how long before and after surgery it should be taken? Thank you.

Manish H. Shah, MD, FACS · Answer

Hello ludmilaag, Thanks for your question.As part of a rapid recovery protocol, all of my cosmetic surgery patients use Arnica and Bromelain.I have found the use of these supplements, amongst others, to be of benefit when preparing the patient's body for a surgical recovery.I usually ask the patients to go to their local health food store and get Arnica Montana 30x and take 4 pellets 3 times a day starting about 1 week before surgery and then lasting up to 2 weeks after surgery.  Bromelain is an enzyme found in pineapple.  I ask patients to drink pineapple juice daily starting 1 week before surgery and then lasting up to 2 weeks after surgery.  Bromelain also comes in tablet form, 500mg daily.I hope this helps?Dr. Shah

Jed H. Horowitz, MD, FACS · Answer

I suggest to my patients beginning supplements such as  bromelain or arnica a week or two before their procedure(s). However, its best to consult with your board-certified Plastic Surgeon beforehand. She or he will make suggestions according to your procedure and medical records in addition to discussing your pre-op preparations. Also, such may be provided for you with your pre-op material and prescriptions in time for your recovery period. You will learn more about preparing at your pre-op appointment.

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question! The recommendations for the use of these homeopathic medications are surgeon preference. I typically suggest the use of Arnica Montana to decrease swelling and bruising. It is an herbal medication that is propagated from the seeds of an herb. I, as well as my patients, have seen some benefit with the treatment in the postoperative period. Although there is little evidence to its effectiveness, I believe there is some benefit, and no harm. I recommend 4-5 tablets under the tongue 4x/day for 3-5 days prior and 5-7 days after the procedure. Hope that this helps! Best wishes!

Arthur Dean Jabs, MD, PhD, FACS · Answer

Arnica Montana and Arnica Senica are plant derived medicines that have been used in Switzerland for over 500 years for their medicinal value. I have personally been using Arnica for over 20 years and find it helps not only with bruising but for swelling and pain as well. Several of my patients have related how it helped other pains they were having not related to their surgery. I typically start Arnica the day before surgery and continue for 10 days or more after.

Franklin D. Richards, MD · Answer

There have been no scientific studies that show Arnica
and Bromelain provide improvement for bruising.However, we have enough anecdotal evidence in our own practice that
shows it helps.We recommend it to our
patients starting two days before surgery and to continue one week after
surgery.There are many good brands
available, and the dosage depends on the brand suggested by your physician.

Babak Azizzadeh, MD, FACS · Answer

I recommend that my surgery patients take Arnica and Bromelaine after surgery and have found that it is successful in reducing bruising and swelling. My surgery patients usually receive a surgery kit which includes a combined Arnica and Bromelaine tablet. I prefer that patients use the pill form as opposed to the cream. I believe that it is more effective and it eliminates having to touch the surgical area to apply. My patients take 2 of these specific tablets once a day for a week following surgery. You would need to consult with your doctor to ask the appropriate dosage for you speficially.

John Michael Thomassen, MD · Answer

Arnica is typically recommend for bruising and bromelaine for swelling.  They are available in a single supplement that is typically started 1 week before and continued for 1 week after surgery.

Larry S. Nichter, MD, MS, FACS · Answer

Bromelain is a type of enzyme found in high concentrations in pineapple plants (and other plants of the plant familyBomeliaceae). Animal studies and anecdotal evidence of the medicinal properties of this pineapple plant extract have brought to light its therapeutic value. Bromelain has also been shown to have low toxicity and produces little to no undesirable side effects.Evidence from decades of research suggests that bromelain is effective at:reducing painreducing edemareducing inflammationimproving the potency of antibiotics.All of these properties are related to important aspects of post-operative healing.The FDA in the United States recognizes bromelain as generally safe, and has categorized it as a food additive. It is commercially available in capsule, tablet, powder, and liquid forms for oral consumption. The recommended dosage varies between 500 to 1,500 milligrams per day.Evidence from early studies indicate that bromelain may be an effective pain reducer. Healthy adults showed a dose-dependent response to the extract, which reduced acute knee pain and appeared to promote their general well-being. Bromelain reduced pain when applied directly to open blisters in another study.Bromelain may reduce healing time for soft-tissue wounds. Patients in one controlled clinical trial who took Bromelain had bruising and faster reduction of edema than patients who did not. Analysis of the results, however, showed that the effect fell short of statistical significance. Results from another study showed that patients who took vitamin supplements containing Bromelain had shortened wound-healing time than those who did not.Bromelain enhances the action of antibiotics. Arnica Montanum orally and in gel form is also thought to be helpful at minimizing bruising but there is not as much scientific studies to confirm this. Most of our patients however feel it works and is tolerated with minimal side effects for most.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

There is not any real hard scientific data out there. Arnica helps decrease bruising while bromelin decreases inflammation/swelling.  In my experience, it is helpful. I typically have patients start it 1-2 days prior to surgery and continue it 5 days after surgery.

Timothy R. Miller, MD · Answer

Probably not.I am commonly asked about the best ways or treatments to prevent or remove bruising.  First, it is important to remember what a bruise is..... a bruise is simply a certain amount of blood located in the skin.  To help prevent bruising we have our patients stop medications such as aspirin, NSAIDs (think Motrin, Advil, Alleve, ibuprofen), and all herbal supplements (which I include Arnica and Bromelain into this group) 2 weeks prior to the procedure.  This is a great first step.  These medications and herbal supplements (including fish oils) can inhibit the formation of clotting, which is important during a facelift or any surgical procedure...that is, less blood, less bruising (remember a bruise is simply blood in the tissues).Next, decreasing strenuous activity immediately after a facelift is helpful too. Too much premature activity increases blood vessel dilation and blood flow leading to potentially more blood "leaking" into the skin; therefore more bruising.Using a drain will physically eliminate blood and therefore typically result in less bruising; thus, the use of drains for a short time after a face/neck lift is a good thing, which is contrary to some opinions.Keeping your blood pressure at normal levels has a tremendous effect on bruising and a low sodium diet (less than 1500 mg /day) has a significant effect on swelling.To eliminate bruising, after a you have one, is difficult and there is no treatment that will immediately remove a bruise.  In some areas a KTP, V-beam, or IPL (less effective) can be used to help hasten the resolution of a bruise.  I have seen remarkable results in most but not all cases.The use of Arnica and Bromelain are commonly used, and I'm OK with their use AFTER a procedure.  However, there are many good studies, in very respected peer reviewed medical journals, demonstrating these supplements are not effective.  There a few small studies reporting good results but I, and many of my colleagues, have issues with the details and statistics of those studies.However, some of my patients do state that Arnica has improved their bruising and most state they achieved better results from the topical use of Arnica versus oral pills--this is of course is anecdotal evidence. Either way, topical or oral, Arnica and Bromelain are typically safe to use after a procedure. I hope this helps.

Does arnica and bromelain really help with bruising and swelling after facelift?

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