October 03, 2026 | Patient Safety, Preparing for Surgery
The Daily Mail called me about a man who eats raw garlic in honey every morning and calls it natural Botox. My answer was about surgery, not his face: “I ask patients to stop garlic supplements roughly two weeks before surgery for the same reason I ask them to stop fish oil and high-dose vitamin E.”
Here is that same rule the way my pre-op nurse gives it on the phone, two to six weeks before surgery. Her words, as spoken.
When do I stop my vitamins and supplements?
Our pre-op nurse: “You’re gonna stop all vitamins, supplements, pre-workouts, or anything that you take that is not prescribed. If you’re taking any prescribed medications, you continue taking them.”
Two weeks out. No list.
Do I have to memorize all of this on the phone?
Our pre-op nurse: “So your vitamins, I’m gonna explain them to you, but it’s a lot. But we’ll be sending you written instructions for everything.”
Our pre-op nurse: “The first one is gonna be with the clearance paperwork that you need to take to your PCP for everything that we need before your surgery. And then the second email is gonna be the email with the copy of your consent, pre- and post-op instructions.”
Two emails, and a box.
What is in the box you send?
Our pre-op nurse: “Our vitamins are called Recovery Support. They help you with the bruising, the swelling, and everything that you need to heal, to have a smooth healing process. It’s a month treatment that you start 2 weeks before, then you finish it 2 weeks after.”
Our pre-op nurse: “One bottle labeled Morning Formula, the other bottle Evening Formula, the third bottle Bromelain. The morning and the evening formula, those are the only ones that you’re going to start. The morning formula is gonna be 3 before breakfast. The evening formula, 3 before dinner. Then you’re gonna continue with the Bromelain, which is gonna be 3 days before the surgery.”
The cabinet closes and the protocol starts the same day.
Why bromelain?
Our pre-op nurse: “Bromelain is what pineapple contains, a natural antibacterial and a natural anti-inflammatory.”
Dr. Agullo: “Arnica and bromelain help with bruising.”
How does the arnica work?
Our pre-op nurse: “That box is actually opened and taped because I labeled every tablet for you. You’re gonna start with the first tablet that is labeled pre-op, 24 hours before the surgery. Then you’re gonna continue with the post-op, that is gonna be 4 hours after surgery. And then at bedtime the day of the surgery. You’re gonna continue with day 2, morning, afternoon, evening. Day 3, day 4, and you’re done. The arnica pills is only a 4-day treatment.”
I am on a GLP-1. Do I stop it?
Our pre-op nurse: “I’m gonna need for you to stop taking it 2 weeks before the surgery and 2 weeks after. The reason why, they slow down your intestinal motility, as well as the surgery, and we do need for you to have bowel movements right after surgery.”
Why am I being put on iron?
Liposuction and tummy tuck patients start iron two weeks ahead. Prescribed, so it stays.
Our pre-op nurse: “The reason why, we do lose a little bit of blood during surgery. So if you lose a little bit of blood and it’s high, it’ll go to normal levels other than having it normal and dropping to anemia.”
Our pre-op nurse (translated from Spanish): “The only difference with the iron we prescribe, we prescribe ferrous gluconate, and usually when you buy over the counter it is ferrous sulfate, and the sulfate causes a little constipation, the gluconate does not, and the gluconate has better absorption.”
Is there anything that speeds up healing?
Dr. Agullo: “We do have something called ElixirMD, which, if you can come every day for five days, it’s an LED treatment, and it speeds up the recovery by, like, twice as fast.”
Dr. Agullo: “NAD infusions with glutathione before and after surgery help clear the anesthesia. Post-op peptides, GLOW for face work and GLOK for body, help with inflammation and tissue regeneration.”
What testing does Dr. Agullo run before surgery?
Dr. Agullo: “Of course, we’re gonna do some lab work, make sure that everything looks good. We’ll check your heart as well before surgery. So it’s a very safe procedure.”
So why no list?
Because a list has an end. Garlic, ginkgo, ginseng, vitamin E, guarana, horse chestnut, policosanol, resveratrol, saw palmetto, turmeric, vanadium: that is the published hold group from a Mayo Clinic Proceedings review, and turmeric is in the spice aisle. Add high-dose fish oil. In a study the American Society of Plastic Surgeons publicized, 17.5 percent of patients would have been at bleeding risk had they not stopped. Nearly one in five.
Garlic in food is fine. What I told the reporter: “One clove in food is not a crisis, but a patient who has escalated to several cloves a day plus a supplement is a patient I want to know about.”
Nicotine is a separate rule, healing rather than bleeding. Own post.
Bring the list. All of it, or a photo of the cabinet.
Why Choose Dr. Agullo
Certified by the American Board of Plastic Surgery and the American Board of Surgery. Mayo Clinic plastic surgery fellowship. Clinical Associate Professor of Plastic Surgery, Texas Tech University Health Sciences Center. Castle Connolly Top Doctor thirteen consecutive years, 2014 through 2026.
Ready to Talk?
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
This is how we do it at Southwest Plastic Surgery. Another surgeon may do it differently and still be right. If you had surgery elsewhere, follow your own surgeon’s instructions.
