Smoking and Plastic Surgery
Everyone knows that smoking isn’t good for you. Smoking can cause lung cancer and heart disease. It prematurely ages the face, causing deep creases, especially around the mouth. Smoking also has a detrimental effect on plastic surgery.
Smoking can cause massive complications after plastic surgery, so much so that I insist my patients quit at least six weeks prior to surgery. The nicotine in cigarettes (and the patch and gum) causes blood vessels to spasm. This means that the blood flow in the presence of nicotine is vastly decreased. Good healing after plastic surgery is dependent on good blood flow to the skin and other structures. Smoking decreases that blood flow, causing an increase in difficulties with wound healing.
Two operations that can have devastating complications in the presence of smoking are breast lift/reduction and facelift. In breast lift and reduction, the blood flow to the nipple areola complex is decreased in order to make a smaller and/or lifted breast. Smoking can cause the nipple areola complex to die. The skin of the breast can also die. Healing after skin death can be a long and painstaking process. Scarring can be significant. If a nipple can be reconstructed, it will never have sensation.
In facelifts, the skin overlying the cheek is separated from the underlying soft tissue, again, decreasing the amount of blood flow to the skin as it heals. In the face of smoking, the cheek skin can die. Healing after skin death of the cheek can be long and painstaking and difficult to hide.
Second hand smoke can also cause these detrimental effects.
For these reasons, I cannot stress enough how important it is to quit smoking before plastic surgery.