Smoking before or after Cosmetic Surgery is a really bad idea. The adverse effect of smoking is not limited to the respiratory system, its restriction of blood flow effects and carcinogenic impact can have widespread effects when you are recovering. With regards to cosmetic surgery, the negative effects of smoking on wound healing are of particular concern. Smoking can also deplete your body’s reservoir of Vitamin C. A Deficiency of Vitamin C can impair collagen synthesis, which can result in disfiguring scar formation after your cosmetic surgeries.
Multiple studies over the last few decades have confirmed that smokers suffer from impaired wound healing, which can be particularly concerning for smokers who plan to undergo cosmetic surgery.
The Harmful Effects of Smoke and Smoking
Tobacco smoke contains various chemicals, including nicotine, hydrogen cyanide, lead, arsenic and so on that is harmful to the human body, and can eventually result in life-threatening complications.
Research has shown that smokers are at an increased risk of developing perioperative and post-operative complications. In fact, most people cannot be considered an ideal candidate for cosmetic surgery unless they completely quit smoking (at least for a period of time before and after surgery). Most surgeons will insist and help their patients stop smoking before performing any surgery on them.
Smoking during the post-operative period can result in impaired wound healing due to poor oxygen supply and utilization. Moreover, collagen deposits are also disrupted, further impacting the wound-healing process. This can result in wide and prominent scars that can negatively affect your body’s aesthetics.
Some of the other potential side effects of smoking during surgery, especially in the postoperative period, are mentioned below:
Tissue hypoxia and skin necrosis
In 1966, research that was conducted and published by Dondero et al showed that smoking decreased cutaneous blood flow. In trying to further understand this decrease in blood flow, a study was performed in 1991, by Goldmine and Bennett where they used a Doppler flow meter to measure the microcirculation of skin surface. Results of the study showed that smoking caused vasoconstriction of the blood vessels, hence, decreasing blood flow.
Another study performed with the purpose of understanding the pathophysiology behind the vasoconstrictions associated with cigarette use found that nicotine causes vasoconstriction directly by stimulating catecholamine release from the adrenal gland.
The eventual decrease in blood flow causes the oxygen levels to drop and results in tissue hypoxia. Nicotine disrupts the balance between prostacyclin and thromboxane A2, a vasodilator and vasoconstrictor respectively. Overall high action of thromboxane A2 leads to tissue hypoxia.
Thrombosis and its complications
Tissue hypoxia leads to increased haemoglobin production which results in increased viscosity of the blood. Ultimately, this can lead to potential thrombogenesis. This thrombus can then be introduced to the bloodstream and lodge in different blood vessels in different organ systems and can lead to the infarction, or infarction-like condition, of the associated organs such as stroke, cardiac arrest, and so on.
Wide and prominent scars
Smoking impairs the normal function of myofibroblasts and fibroblasts; cells that are required for normal wound healing.
A study performed by Wong and his team showed that cigarette smoking hindered the normal migration of fibroblasts. He observed that fibroblasts initially failed to migrate to the wound site and those that had migrated, remained in the wound site promoting excess scar formation.
Furthermore, excessive nicotine use can block TGF-B1, hence, transforming growth factors that induce separation of myofibroblasts. This results in a decrease in the contractile function of normal healthy skin.
Cosmetic Surgery, Smoking, and the Consequences
Smoking has a negative effect on the healing of all surgical procedures; cosmetic and medical. In cosmetic surgery, smoking severely impairs the healing process of surgeries that are performed for undermining of skin flaps. The removal of excess tissue and the healing of the remaining tissue is determined by the proper blood supply.
Since smoking reduces the dermal blood flow, healing will be significantly impaired, leaving behind scars that make the cosmetic surgery procedure redundant.
Various research has been conducted with the main purpose of understanding the several consequences of smoking on the surgical and post-surgical, healing processes.
Nolan et al Research
Craig & Rees Research
Rees Research
There is scientific evidence explaining how smoking can affect the results of your cosmetic surgery. However, these consequences can be avoided by the cessation of smoking.
A joint new study conducted by WHO (World Health Organization), WFSA (Australia and the World Federation of Societies of Anesthesiologists), Newcastle University has shown that smokers who quit approximately 4 weeks or more before surgery have a decreased risk of developing complications. They are also most likely to see the results of their surgery within 6 months.
It is a well-known fact that cessation of smoking is not an easy task. You can opt for one of the following methods which will prove to be quite beneficial in helping you quit smoking.
Non- Nicotine Therapy
Psychological treatment
Counselling and self-help programs
Nicotine Replacement Therapy
Postponing your surgery
How long do I have to stop smoking before going for surgery?
Will my surgeon do the surgery if I continue to smoke?
Dr. Carmen Munteanu MD. FRACS(Plas) is a well-trained and highly skilled plastic surgeon specializing in aesthetic breast surgery and body contouring. She has over 25 years of experience and is best known for her high patient satisfaction rates. She approaches all surgeries with up-to-date approaches to help her patients achieve their dream look.