Harmful Consequences of Smoking and Plastic Surgery

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Plastic surgery procedures do not mix well with smoking. Cigarettes contain over 4000 substances. Nicotine increases the risk of surgical complications (notably pulmonary complications), delays and contributes to poor healing, and is a source for tissue death. 

Cigarette smoking decreases cutaneous blood flow by 38% in habitual smokers and 28% in casual smokers who may only have one cigarette. This is why delayed and poor healing occurs among smokers who have plastic surgery.  Cigarette smoking increases the heart rate and systolic blood pressure which can contribute to complications during surgery. The carbon monoxide contained in cigarettes be a factor in cardiovascular breakdown and has resulted in sudden death.   

Plastic surgeons recommend smoking cessation at least two weeks, if not four weeks, prior to surgery to reduce the risk of complications. Smoking is prohibited after surgery to ensure optimal wound healing results. Plastic surgeons may require a cotinine test to uncover levels of cigarette substances prior to surgery. They may repeat the test on the day of the procedure as well. Plastic surgeons can identify levels in urine through the cotinine test which are often 10 time higher in those who smoke.

Smoking Cessation Aids
The good news is that there are many methods available to quit smoking, including:

• Nicotine replacement gums
• Nicotine replacement lozenges
• Nicotine replacement patches
• Nicotine replacement nasal sprays
• Nicotine replacement inhalers
• Prescription medications such as Chantix, Bupropion, and Nortriptyline.
• Quit smoke hotlines that can be found online.

It is critical to inform your plastic surgeon about the amount of smoking you do at the time of the initial consultation and before surgery so that precautions can be taken.

If you want to find a board certified plastic surgeon in your area, click here.


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