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915 Olentangy River Road, Suite 2140
Columbus, OH 43212
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Fax: 614.293.9024

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Put Down That Cigarette: Smoking and Plastic Surgery Don’t Mix


"No smoking sign"

Put down the cigarette

If you’re a smoker, and you’re planning on having surgery, you may want to drop that smoking habit-if not permanently, then temporarily at least. In most surgical procedures smoking before and after surgery introduces a host of potential complications, both with the anesthesia and healing process. Quitting smoking anywhere from four to six weeks before your surgery can decrease your risk of surgical complications tremendously, and staying smoke and nicotine-free for the same amount of time afterward can reduce the risk of healing complications. But you may ask, “Why do I need to stop smoking? How bad could it be?”

The first danger is when general anesthesia is administered. Smoking increases mucus, and the airways in the lungs of smokers are generally more narrow and prone to collapse than in non-smokers. If you’re a smoker, your chances of a respiratory infection are higher, and you’re more likely to develop pneumonia or other complications from the anesthesia.

Another danger is the smoke itself. The carbon monoxide in cigarette smoke binds with the red blood cells, decreasing their ability to transport oxygen to the body’s tissues. Of course, every cell in the body requires oxygen to function, and even more so when that cell is trying to repair itself. The kicker? Carbon monoxide attaches to the hemoglobin (responsible for your body’s oxygen transport) in the blood more easily than the oxygen does. Less oxygen to the cells means less oxygen to the tissues, which may delay the healing process by quite a bit.

But smoke isn’t the only thing that affects the surgical outcome. The nicotine in a smoker’s body acts as a vasoconstrictor- meaning all the blood vessels are constricted, or more narrow than they should be. This prevents the blood from flowing as it should. When you pair this with the low blood oxygen levels from the smoke itself, you have a problem.  Now not only do you have blood with reduced oxygen, but it isn’t flowing very well, either.

These are extremely important when dealing with breast reconstruction, as often a piece of living tissue is taken from one part of the body and moved to the chest to construct a breast. Since the tissue is alive, a good blood supply is crucial. Without a good blood supply tissue death could result. If you haven’t seen tissue death, called necrosis, it isn’t pretty. The affected area can turn completely black. At this point, you can most likely plan for yet another surgery to deal with the necrosis.

If you’re lucky, and manage to escape the process with no necrosis, your chances of larger or more prominent scars increase.

This is by no means an exhaustive list, but hopefully you now have a better idea of why your surgeon is asking you to stop smoking.

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