Smoking and plastic surgery

Smoking and plastic surgery


Smoking is bad for plastic surgery. It can lead to complications and adversely affect the outcomes of a surgical procedure. This can be due to various reasons. Let me elaborate. 

1. Increased risk of infections due to a reduction in the blood supply to the tissues. Infections can result in delayed recovery, and more scarring. All these lead to suboptimal outcomes. 
2. Increased anesthesia complications. Smoking negatively affects the functioning of multiple organs. These include greater incidence of pneumonia, and cardiac events. They are associated with greater morbidity after a surgical procedure. 
3. Delayed wound healing. Wounds require adequate blood supply to help heal the tissues. By reducing the blood supply smoking reduces the availability of nutrients that are important in wound healing. Delayed wound healing means longer time to recover, and to return to routine activities. Delay in healing may also necessitate additional surgical procedures to achieve wound closure. All these lead to increased expenses. 
4. Increased risk of postoperative bleeding. Smokers are seen to have an increased risk of bleeding. Hematomas or collections of blood are more common among smokers. Even though most hematomas are managed without surgery, they can be associated with prolonged recovery and more scarring.

When to stop smoking before surgery? 
The best time to stop smoking is now. The negative effects of smoking reduce after cessation of smoking. We usually advise a period of 4 to 6 weeks of abstinence before undertaking any surgery. 
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Plastic surgery can involve extensive dissection of the tissues. This makes healing more dependent on adequate blood supply of the treated tissues. Because of the above reasons, smoking is a strong contrindication for surgery. Smoking is also one of the common reasons for postponement of the surgery in our practice. We usually choose to schedule surgery after a period of abstinence from smoking. 


For further reading about the effect of smoking during surgery, please visit: 
https://www.who.int/news/item/20-01-2020-smoking-greatly-increases-risk-of-complications-after-surgery