Bromelain And/or Arnica Before Surgery?

I'm having revision lower blepharoplasty next month. I had bruising for 6 weeks after the first surgery. Do you recommend Bromelain and/or Arnica before surgery as well as after? My Dr. seemed somewhat indifferent to there use. If I do take these herbs, how much and when should I start taking it? I really don't want to be in hiding for another six weeks!

Doctor Answers 16

Arnica for Blepharoplasty

Arnica pills when taken starting the day before surgery and after surgery until any possible bruises are gone will reduce bruising and make them go away faster if you get any. Arnica cream afterwards helps as well if needed. Also avoid aspirin and ibuprofen for 10 days prior to surgery.

Reduce Swelling after Eyelid Surgery

The eyelids are notorious for bruising and swelling. If a movie wants to convey that an actor has been in a fight, the first make-up applied is that for a black eye.

For eyelid surgery, 4 main treatments exist for minimizing bruising, but unfortunately no "silver bullet" prevents completely.  The first is starting Bromelain & Arnica prior to surgery.  (A few studies in the medical literature show improvement but admittedly others show no difference).  The second is largely out of your control and involves surgical technique.  The third treatment is 48 hours of post-operative icing.  Ice remains one of the most powerful anti-inflammatory agents, and I advise a maximum of 30 minutes every hour.  After that period, transitioning to warm packs also helps. The fourth treatment for facial bruising that is remarkably effective is a Pulse-Dye laser.  It will not erase the bruise but it can fade it significantly and speed the rate at which it disappears.

Best of luck in your recovery.

Jeffrey Cone, MD
Austin Plastic Surgeon
5.0 out of 5 stars 4 reviews

Arnica Before Blepharoplasty

I routinely recommend Arnica before and after surgery.  This can be purchased at most pharmacies, over the counter.  There are instructions with the medication of when it should be taken and should be started the evening before surgery.  So, don't look at the package the morning of surgery because it may already be too late.  Remember that these medications are herbal and not FDA approved.  So, the studies demonstrating effectiveness are not great.  I have attached a link to a patient who is one week out from a lower blepharoplasty (and facelift/browlift, lip augmentation) that I consider a normal, expected amount of bruising after having taken Arnica. 

John Bitner, MD
Salt Lake City Facial Plastic Surgeon
5.0 out of 5 stars 62 reviews

Arnica After Surgery

Great question!  Arnica has been used for centuries to treat the effects of accidents and injuries and has been known for its remarkable healing properties.  Many physicians and patients around the world have successfully used Arnica to treat bruising, soreness, inflammation and swelling that results from all types of physical trauma. Arnica has had the reputation for safety, effectiveness, ease of use and broad applicability. According to further studies and research, Arnica may be useful in treating health problems related to arthritis, post-surgical swelling, post-surgical pain and muscle soreness.  Please speak to your plastic surgeon for details on dosage.  

Jon Paul Trevisani, MD, FACS
Maitland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Eyelid revision: arnica for bruising

Revision eyelid surgery should be done at least 6 months after the initial surgery to allow time for healing and tissues to soften. Asymmetries, excess skin, fat rolls, fat malposition can all be improved. Other treatments may include laser or chemical peels to tighten skin and improve texture

I routinely have my patients use Bromelain and arnica and arnica gel before and after surgery

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 48 reviews

Bromelain and Arnica for Surgery

There is little scientific evidence to support the use of herbal supplements to improve the rate of healing, bruising, or swelling after eyelift surgery. Most plastic surgeons feel that they are safe and do not interfere with recovery. Discuss use of these substances with your surgeon.

Lara Devgan, MD, MPH
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

Herbal supplements for bruising

The is no hard evidence that any over-the-counter products have any benefit for post-operative bruising. There is probably no harm either, so I let patients know about Arnica and other supplements. I think the most important steps to diminish bruising following surgery are cold compresses for 3 days and keeping the head elevated for 1 week. 

Arnica and Bromelain ointment with Bruisestick

Arnica and Bromelain are excellent post op supplements for cosmetic surgery. I prescribe Bruisestick ointment which contains both Arnica and Bromelain. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 74 reviews

Medication to prevent bruising

Bruising is expected after eyelid surgery and it usually resolves after 7 to 10 days.  Persistent bruising and discoloration of the soft tissues can occur.  There is really no magic cure as this will ultimately resolve on its own.  Occasionally alternating warm and cool compresses can help as well as on over the counter herbal product, Bromelean.  The usual antibruising dose is 500 mg twice a day between meals. Arnica can be used prior to surgery, a good product to try from

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 14 reviews

In my experience, Arnica pills are helpful for minimizing post-operative bruising.

In my practice, I routinely give all of my surgical patients Boiron, arnica pills which are begun 48 hours before surgery, and are continued for 7-10 days. This herb appears to lighten dark bruising, especially after rhinoplasty or blepharoplasty, and makes it easier to use concealer and resume normal social activities.

This is anecdotal, but in my opinion, Boiron arnica montana pills appear to be effective in minimizing post-operative bruising. I have never offered bromelain to my patients.

Hope this is helpful for you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 358 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.