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Arnica, Bromelian and Ice for Facelift?

Dr. Dean Kane Q & A shutterstock_77837938 Q. I am having a facelift. I have had other plastic surgery done where I have used Arnica & Bromelain prior and post-surgery. This doctor has asked me not to use it. I felt it reduced bruising for my other procedures. Has the surgical community changed their mind? My surgeon also stated he doesn’t use ICE post-surgery? I have used it for other facial procedures- just wondering why I can’t? When I asked he stated it isn’t needed because I will be on Prednisone. Any insight? I will ask him again. A. ​Procedures which cut the skin in one plane and separate (ie, incision) retain more circulation than those such as a facelift which cut the skin in 2 or more planes and divide feeding blood vessels to the skin (ie, flap). ​ ​The dynamics of healing in most individuals follows a very anticipated path. A desire to heal faster, with less swelling and bruising by every patient is anticipated but must be balanced against side-effects and risks. ​ ​Arnica, bromelain, ice and steroids all affect the tissues differently.
  • ​Arnica montana is generally felt to have anti-oxidant and NSAID-like (ibuprofen) anti-inflammatory effects. While there are no defining studies, it is found no better than placebo.
  • ​I have found bromelain, the active enzyme in fresh pineapple to be helpful post-operatively to reduce bruising.
  • ​Since there is difficulty in monitoring the use of ice which reduces bruising but also reduces circulation to and within the flaps, “frost-bite” due to freezing of the skin has occurred. I, too, order against the use of ice as the risk of bruising is easier to treat than the necrotic loss of skin.
  • I do use steroids at the time of surgery to reduce bruising, swelling and stabilize the injured cells during the immediate procedure and if necessary for a very short period of time thereafter. Again, the risk of use is always balanced against its’ non-use.
Another concern to discuss is the use of drains and/or tight, firm or lose bandages. Swelling and bruising may be diminished in using compressive bandaging but they also reduce blood flow and therefore risk skin necrosis; particularly with flaps. I prefer the use of elevation of the surgical area, suction drains and loose dressings with no use in compression garments for flap surgery. ​ In over 30 years of surgery, I have not found the use of these supplements and medications to have changed. They are used as individually as the patients and the surgeon. ​ ​I hope this was helpful. Good luck with your surgery!
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