Smoking and its Harmful Effects on Plastic Surgery

Our own Dr. Jennifer Walden was recently featured on Fox News to discuss the risks of smoking. We all know smoking is detrimental to our health, but what Dr. Walden didn’t have a chance to mention was how harmful smoking can be for surgical patients. The challenges of permanently kicking a nicotine habit are discussed in the clip above, and many patients struggle to quit temporarily in the pre- and post-op period.

With respect to wound healing after surgery, smokers already have some degree of permanent constriction of blood vessels, which is known as "vasoconstriction." So these patients are already at a disadvantage as compared to non-smokers when heading into surgery, such as increased pulmonary and heart risks associated with sedation and general anesthesia, as well as decreased blood supply to the skin and deeper tissues needed desperately for nice incisions to heal with the best scars possible. Smoking during the recommended four week abstention period surrounding surgery can leave patients vulnerable to complications, such as:

• Poor and/or delayed wound healing
• Increased risk of infection
• Longer bruising period
• Skin loss
• Hypertrophic or keloid scarring
• Increased risk of pulmonary problems
• Flap necrosis (as with “flap” procedures) or tissue breakdown

Quitting two weeks prior helps to rid the majority of nicotine from the body, while the remaining traces are flushed out during the initial period following surgery. However two weeks is no magic number for quitting and the longer the period of abstinence before, the better, most experts agree.

Rod J. Rohrich, MD from the University of Texas Southwestern Medical Center explains, "Tobacco smoke contains more than 3,800 identified substances, of which nicotine and carbon monoxide are two of the most detrimental to wound healing and may cause pulmonary complications. This impaired wound healing may dramatically decrease the final cosmetic outcome."

Considering people generally invest in plastic surgery to improve their appearance and self-confidence, it may be the perfect time to use one's surgery date as a goal and quit smoking altogether!