Integrative Medicine in Plastic Surgery

Abstract

Background: Surveys have reported that as high as 80% of plastic surgery patients utilize integrative medicine approaches including natural products (NPs) and mind-body practices (MBPs). Little is known regarding the evidence of benefit of these integrative therapies specifically in a plastic surgery patient population. Methods: We conducted a systematic review of studies in MEDLINE, PubMed, and EMBASE (inception through December 2016) evaluating integrative medicine among plastic surgery patients. Search terms included 76 separate NP and MBP interventions as listed in the 2013 American Board of Integrative Health Medicine Curriculum. Two independent reviewers extracted data from each study, including study type, population, intervention, outcomes, conclusions (beneficial, harmful, or neutral), year of publication, and journal type. Level of evidence was assessed according to the American Society of Plastic Surgeons Rating Levels of Evidence and Grading Recommendations. Results: Of 29 studies analyzed, 13 studies (45%) evaluated NPs and 16 (55%) studied MBPs. Level II reproducible evidence supports use of arnica to decrease postoperative edema after rhinoplasty, onion extract to improve scar pigmentation, hypnosis to alleviate perioperative anxiety, and acupuncture to improve perioperative nausea. Level Vevidence reports on the risk of bleeding in gingko and kelp use and the risk of infection in acupuncture use. After year 2000, 92% of NP studies versus 44% of MBP studies were published (P = 0.008). Conclusions: High-level evidence studies demonstrate promising results for the use of both NPs and MBPs in the care of plastic surgery patients. Further study in this field is warranted.

Integrative Medicine and Plastic Surgery: A Synergy—Not an Antonym

“…The use of herbals like Gingko caused bleeding in a blepharoplasty patient and a perioperative therapy with acupuncture was associated with a risk of wound-site infections in a lipoplasty patient [ 27 , 28 ]. Taking into account this important information, we believe that all integrative approaches, which have been described so far mainly in aesthetic-surgical patients, can be applied to all areas of plastic surgery [ 11 , 27 ].…”

“…The field of complementary medicine, as far as natural products are involved, is already present in plastic surgery [ 11 ]. For example, Arnica montana , onion extract, Vitamin E products, and Melitolus are considered beneficial [ 11 ].…”

“…The field of complementary medicine, as far as natural products are involved, is already present in plastic surgery [ 11 ]. For example, Arnica montana , onion extract, Vitamin E products, and Melitolus are considered beneficial [ 11 ]. Mind and body practices, such as hypnosis and meditation, are also known to have a positive effect on the postoperative course of plastic surgery patients [ 11 ].…”

“…For example, Arnica montana , onion extract, Vitamin E products, and Melitolus are considered beneficial [ 11 ]. Mind and body practices, such as hypnosis and meditation, are also known to have a positive effect on the postoperative course of plastic surgery patients [ 11 ]. It should also be mentioned that therapeutic concepts of integrative medicine can be applied in all four pillars of plastic surgery (aesthetic surgery, reconstructive surgery, burns, and hand surgery) [ 2 , 11 , 12 , 13 , 14 ].…”

“…Mind and body practices, such as hypnosis and meditation, are also known to have a positive effect on the postoperative course of plastic surgery patients [ 11 ]. It should also be mentioned that therapeutic concepts of integrative medicine can be applied in all four pillars of plastic surgery (aesthetic surgery, reconstructive surgery, burns, and hand surgery) [ 2 , 11 , 12 , 13 , 14 ]. However, little is known about the impact of a broader integrative concept that is based on anthroposophic medicine and combines these individual offerings and procedures, as the utilisation of IM in plastic surgery departments seems to be under-frequented [ 2 ].…”