This objective of this study was to report the incidence of dietary supplement use in facial cosmetic surgery patients in the United States. Dietary supplements are not regulated by the Food & Drug Administration (FDA) and some have been known to cause coagulopathy, hypertension and also dry eyes. Therefore, advice to stop these prior to surgery is an important consideration. A retrospective review of 200 patients over the age of 15 who had undergone a variety of facial cosmetic procedures by a single surgeon was undertaken. Supplements including vitamins, minerals, herbal and botanical supplements, amino acids and other substances not typically considered food or part of a meal being taken by the patients were recorded. The incidence of supplement use was 49% with the majority of these (24.5%) using vitamins and minerals only. Only animal or plant-based supplements were being used by 2.5%. Supplement users tended to be older (51.4 years vs. 38.5 years) and more likely to be female (89.8%). The average number of supplements taken was 2.8, with the most common being vitamin D with the second most being multivitamins. One patient was taking 28 supplements in total. Dietary supplementation use is prevalent in the surgical patient population and so it is important to take a thorough medication history, as most patients tend not to report their use to the physician unless specifically asked for. Apart from potential side-effects, some herbal supplements combined with various medications can be hepatotoxic. This study did not look directly at whether patients undergoing facial cosmetic procedures had a higher incidence of herbal medication use compared to the general population although other studies have shown this to be the case. Other limitations of this study are that it is retrospective and the number of patients reviewed is small. 

The incidence of vitamin, mineral, herbal, and other supplement use in facial cosmetic patients.
Zwiebel SJ, Lee M, Alleyne B, Guyuron B. 
PLASTIC AND RECONSTRUCTIVE SURGERY
2013;132:78-82.
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Zeeshan Sheikh

NHS Lothian, UK

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