Complications from supplement use in aesthetic surgery are similar to those seen in general surgery and other emergency procedures. Long-term or excessive use of supplements may interfere with intraoperative management and impair postoperative wound healing.
Caution is needed with supplements containing ingredients that may affect bleeding, coagulation, or interact with anesthetic agents. It is essential that patients have a full and direct discussion with their surgeon and anesthesiologist regarding all supplements they are currently or have previously been taking — including the product names, duration of use, and dosage. This allows the medical team to determine whether additional laboratory tests are needed, select appropriate anesthetic drugs, choose the safest surgical approach, and plan postoperative care to promote faster wound healing.
Many collagen-based supplements today are enriched with hyaluronic acid, vitamin C, or glutathione — ingredients known for their strong water-retention properties. When water accumulates excessively in tissues, it can lead to edema, tissue laxity, and poor structural definition, making dissection more difficult during surgery and increasing the risk of diffuse bleeding.
When soft tissue retains excessive water over a prolonged period, it causes the following issues during surgery: Edematous tissue with less defined anatomical planes makes precise dissection more difficult for the surgeon. Increased capillary permeability leads to diffuse bleeding that is harder to identify and control. There is a higher risk of postoperative seroma or hematoma, which may prolong recovery time.
Difficulties in breast augmentation surgery with patients who use dietary supplements, Dr. Ho Cao Vu shared: "The use of the ultrasonic surgical scalpel in breast augmentation, mastopexy, and abdominoplasty offers the advantage of sensing the moisture level of the tissue — whether dry or wet — to optimize cutting, sealing, and coagulation. This reduces the risk of intraoperative and postoperative bleeding, tissue trauma, and thermal injury. However, in patients who have used dietary supplements long-term, the tissue tends to retain water and become lax, which presents a challenge during pocket dissection for implant placement."
“Wet tissue increases the risk of bleeding. Lax tissue makes hemostasis more difficult for the surgeon. It increases the risk of seroma. If the surgeon fails to assess the degree of tissue hydration and laxity in order to plan appropriate surgical and postoperative strategies, the risk of seroma increases. Patients may need to take additional medications to suppress fluid secretion in the implant pocket after wound closure.” The surgeon further shared the intraoperative challenges in cases involving water-retentive soft tissue.
The use of dietary supplements and collagen in the preoperative period carries potential risks that may directly affect coagulation, hemostasis, and surgical technique.
Many ingredients commonly found in supplements — such as garlic, ginkgo biloba, turmeric, or echinacea — have been shown to increase the risk of bleeding or interact with anticoagulant medications, even when standard coagulation test results are within normal limits.
In addition, collagen supplements, due to their strong water-retention properties, may lead to tissue edema and softening of connective tissue, increasing the complexity of tissue dissection and intraoperative bleeding control.
To ensure surgical safety and minimize complications, experts recommend the following:
- Discontinue all dietary supplements at least two weeks prior to surgery
- During the pre-anesthesia evaluation, patients should disclose all dietary supplements they are taking, including non-prescription and over-the-counter products
Proactive screening and timely discontinuation of these risk factors are essential steps to ensure patient safety during surgical procedures and to support optimal postoperative recovery.
