A recent study in Plastic & Reconstructive Surgery showed that 50% a single plastic surgeon’s last 200 patients take supplements. A significant number of supplements can cause bleeding issues that can cause unfavorable outcomes and complications with plastic surgery. The study cited some of the most common as omega fatty acids, bilberry, bromelain, fish oil, flax seed oil, garlic, methylsulfonylmethane, selenium, and vitamin E. Others include ginkgo biloba, St Johns Wort, chia seeds, ginseng and many others. Prior to surgery, Dr. Burroughs generally recommends his patients stop herbal supplements a few weeks prior to surgery so their effects can be “washed” out. Bromelain, found in pineapples, is thought to be helpful to improve bruising and swelling. However, if taken, before surgery it can worsen bruising and swelling. NSAIDS (e.g., Alleve, Motrin) and aspirin should also be avoided prior to surgery. Whenever one is to undergo plastic surgery or another significant surgery it is best to list all medications, vitamins, and supplements so your surgeon can advise if any should be stopped. When in doubt, it is just best to stop them all. Aspirin discontinuation should be discussed with a patient’s primary care physician or cardiologist if it has been prescribed. Excessive bleeding while undergoing eyelid surgery has led in rare circumstances to orbital hemorrhage and blindness, so this can be a serious matter.