November 29th, 2011 Miguel A. Delgado Jr, MD
Many San Francisco Bay Area patients ask “How critical is it to stop smoking before surgery, such as a facelift, tummy tuck or breast surgery?” My answer is that it is extremely important for all surgeries; smoking can increase inflammation and cause severe skin healing issues including skin loss and necrosois of the skin resulting in significantly more healing.
Smoking increases carbon monoxide and nicotine in your blood. Nicotine closes the blood vessels responsible for bringing oxygenated blood to the tissues. Besides its healing power, oxygen also fights infection and helps to keep tissue alive, as well as delivering important medications like antibiotics. Furthermore, smoking clogs the lungs, and thus increases risk of pulmonary infection such as pneumonia. Nicotine also contributes to increased platelet adhesiveness which can increase the risk of blood clots.
Studies show that nicotine gum is not an alternative as the nicotine can interfere with healing the same way it does with cigarettes. Second hand smoke may also delay healing.
At the 2010 annual meeting in San Diego, California of the American Society of Anesthesiologists a study was presented that showed smokers were:
1. 50% more likely to develop pneumonia
2. 57% more likely to have cardiac arrest
3. 80% more likely to have a heart attack
4. 73% more likely to have a stroke
For patients planning elective surgery such as breast reduction, liposuction and breast augmentation, this is an exciting event. Having surgery can be somewhat stressful, and trying to quit smoking when under stress is even more difficult. For most patients I require them to be smoke free for a minimum of two weeks before and two weeks after surgery, but prefer a month. All precautions are taken to ensure the safety of the patient. If you are a smoker and are considering surgery, try to stop smoking as soon as possible then reward your efforts with the surgery you desire.