Dr. Robert Morin: We're discussing the interaction between cigarette smoking and plastic surgery. Everyone is aware of the detrimental medical facts of smoking. What people often aren't aware of, is that cigarette smoking prevents proper wound healing and it also increases the risk of almost every potential complication within the field of plastic surgery.
There are certain procedures that I will absolutely not perform on a smoker, because the risk of complications is too high. For example, a breast reduction is not a good operation to perform on a smoker, because the blood supply to the nipple could be compromised and the nipple could actually not survive. In addition, a face-lift is another procedure where the blood supply is significantly compromised and significant wound healing complications are possible in the presence of cigarette smoke.
So, the nicotine in the cigarette smoke causes constriction of blood vessels, decreased blood flow to the skin, and poor wound healing. So, there can be no nicotine in the blood of a plastic surgery patient, if one wants to decrease the risk of after surgery wound healing complications as much as possible. So for some procedures, smoking is tolerated , however, for most procedures, it increases the risk of complications exponentially and smoking should be stopped at least one month before surgery and non-smoking should be continued at least one month after surgery. In addition, second-hand smoke counts as smoking as well so plastic surgery patients should stay away from their own cigarette smoking, but second-hand smoke as well.