Smoking and Surgery

By Jerome Edelstein, MD

Most of us know that smoking isn’t good for us, but not all of us are aware that the habit is particularly dangerous when associated with plastic surgeries. Smoking puts unnecessary stress on the heart while also complicating wound healing and breathing, marking the habit as a significant risk factor that should be avoided by all plastic surgery patients. SMOKING RELATED COMPLICATIONS FROM PLASTIC SURGERY

Your Breathing

Smokers are more likely to experience breathing problems following surgery than non-smokers (40% compared to 11%) because tobacco smoke damages the lining of the lungs. When the lungs are compromised, they are less efficient in clearing away waste (secretions and particles). This, coupled with the decreased efficacy of a smoker’s immune system, can lead to post-operative infections and/or pneumonia.

Your Heart

The nicotine in cigarettes affects nervous systems, leading to faster heart rates (heart stress) and high blood pressure. Combined with the carbon monoxide present in tobacco smoke, a substance that reduces the body’s ability to transport oxygen to the heart, smokers become much more susceptible to heart attacks (at a rate of 80% higher than non-smokers). Heart stress is also much more commonly witnessed by anaesthesiologists.

Infections

A smoker’s compromised immune system leads to a rate of post-operative wound infection that is six times higher than non-smokers.STOPPING SMOKING BEFORE SURGERYFortunately, patients who stop smoking before surgery are able to protect themselves from many of the complications that can occur during their procedure. Taking this precaution reduces surgical risks and may help create a more successful treatment outcome.

Cigarette smoke contains carbon monoxide that reduces the ability of the red blood cells in a smoker’s body from transporting oxygen throughout the body. The presence of carbon monoxide in the blood is reduced by half when no cigarettes are smoked for four hours and, better yet, is reduced to a safe level if cigarettes are avoided for eight hours. Stopping smoking before and after surgery helps oxygen to more effectively travel throughout the body, an essential tool in warding off infection and successful wound healing.

We recommend that patients stop smoking four weeks prior to their aesthetic surgery. This is particularly critical with respect to procedures that involve manipulating the blood flow to tissues: facelifts, tummy tucks breast lift and breast reduction. We feel so strongly about this that we recommend you do not proceed with the above surgeries if you can’t stop smoking for the recommended four weeks. It’s just not worth it. During those four weeks, however, the use of smoking cessation aids, such as the nicotine patch, zyban, and chantix, are useful for those who find it hard to quit “cold turkey”.