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Is CBD Safe to Use After Cosmetic Surgery? A Board Certified Plastic Surgeon Cautions Patients

August 22, 2019 by

Is CBD oil safe before surgery?

While some states are slowly adopting more lenient laws regarding the recreational use of marijuana, it is a byproduct of this plant that seems to be taking the country by storm. Whether it is tinctures to manage physical pain and anxiety, or topical creams and smokeable “joints,” CBD appears to be the latest “cure-all” craze—and users are flocking to pharmacies and pop-up dispensaries in droves.

CBD is considered to be generally safe by many, but the popularity of the product has far surpassed current regulation. Unregulated, synthetic products should be avoided entirely and even regulated CBD should not be taken immediately before or after surgery.

As a physician, I must weigh the popularity vs. the published research for medical and health-related products. While CBD oil does appear to have potential as an effective treatment for some people, it’s important to know the possible risks before using or consuming CBD.

I have recently had some patients ask about using CBD oil before and after elective surgery, and I want to clear a few things up to ensure that patients have a safe surgery and recovery.

What is CBD?

Cannabidiol (CBD) is one of the main extracts of the marijuana plant, second only to tetrahydrocannabinol (THC, the psychoactive component of marijuana). While it has experienced a boom in popularity over the last few years, this derivative from the hemp plant has a long history, with documentation of therapeutic use dating back to 2737 BC.

There are a number of studies that suggest that CBD can be a powerful alternative for managing epilepsy, insomnia, and mental health disorders, however, the popularity of the product has far surpassed current research on its effectiveness.

Is CBD legal in Texas?

Earlier this summer, Governor Greg Abbott signed a bill making the production of hemp and hemp-derived CBD legal in Texas. While producing and purchasing CBD products is now technically legal, many available products are still unregulated and could contain more or less CBD than advertised, have undisclosed ingredients, or could be concocted with synthetic cannabinoids. Commonly found in gas stations and convenience stores, synthetic cannabinoids are completely unregulated and pose significant risks.

CBD may now be legal, but that doesn’t mean it’s safe: the FDA has issued a warning about synthetic, contaminated CBD products.

Just because a product is legal does not mean it is guaranteed to be safe. The FDA released a warning last year about the health risks of synthetic cannabinoid products, which were found to be contaminated with the rat poison brodifacoum. After ingesting these products, many people experienced vomiting, increased heart rate and blood pressure, and even violent behavior and suicidal thoughts. Synthetic cannabinoids have now been linked to severe, uncontrolled bleeding and death. Hundreds of people across several states have been affected negatively by CBD products.

Should I stop taking CBD before cosmetic surgery?

CBD is used widely in the self-management of pain and anxiety, so many patients wonder if they can ingest CBD oil drops or tinctures before their cosmetic procedure and during their recovery. CBD products should not be taken in the days before or after surgery.

We have an incomplete understanding of how CBD interacts with other medications and how it may impact our body systems, but research has found that it has an anticoagulant effect, which puts patients at risk for increased bleeding during and after surgery. Abundant or easy bleeding after surgery can result in the need to return for another, unanticipated surgery to correct the bleeding problems, asymmetry, and tissue death after surgery.

Just as I ask patients to stop taking herbal supplements, vitamins, and nicotine (and even seemingly harmless beverages like green tea) to ensure there are no problems with anesthesia or increased bleeding, CBD products should be stopped two weeks prior to surgery.

CBD products also have a potent reaction with an enzyme system in the liver that can prevent other medications—such as anesthesia medications or prescription pain killers—from using the same system, leading to a build-up in your system and preventing the medications from doing their job.

The unregulated nature of CBD means that dosing has not been defined and that different brands offer a wide variety of strengths available for purchase. The current state of the CBD industry is like the wild west of supplements, and without truly scientific data, we must err on the side of caution.

Can I smoke pot before surgery?

I encourage patients not to smoke anything before a procedure. Many patients falsely believe that smoking marijuana is a safer choice than cigarettes, which is not true—particularly when it comes to surgery. Smoke of any kind in the lungs can lead to respiratory distress, and marijuana itself can interfere with anesthesia, leading to a higher risk of pneumonia after surgery and a higher risk of airway emergencies. Much like nicotine, marijuana also causes delayed healing and poor scarring of your surgical sites. If you live somewhere where marijuana is legal, edibles are a better choice for eliminating the respiratory problems, however, be sure not to eat past the allowed time before surgery.

It’s crucial to be transparent with your physician; we’re not here to judge, but rather to keep you safe

Before any procedure, it’s important that you share any medications, herbal supplements, or vitamins you take regularly with your surgeon, in addition to information about lifestyle habits like drinking, smoking, and drug use.

As a board certified plastic surgeon, my job is not to pass judgment on your personal decisions or lecture you. However, once you are in my operating room, my ability to perform your procedure safely is very much affected by what you put in your body and whether or not you share that information with me. Something as seemingly innocent as CBD oil drops can lead to surgical complications that can, in turn, impact your wellbeing and your results.

If you are ever unsure about what you can or cannot take prior to surgery, please contact your surgeon for their specific pre-op and post-op instructions.

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