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Smoking and plastic surgery - What are the risks?

Written by Mrs Effie Katerinaki - Consultant Plastic Surgeon

Smoking and plastic surgery - What are the risks?

Plastic surgeons have traditionally been asking their patients to stop smoking prior to surgical procedures. Why is this important? 

Smoking is a major risk factor for wound healing complications that often result in poor quality scarring. Nicotine causes narrowing of blood vessels and therefore interferes with the delivery of oxygen and nutrients to the healing tissues. It also causes damage to the regenerative cells and interferes with their function at a time when they are most needed to repair the surgical wounds. Both of the above effects are particularly detrimental when large incisions and dissection of the tissues takes place, such as in breast reductions or uplifts, face lifts and tummy tuck operations.

Apart from its effects on wound healing and tissue regeneration, smoking causes changes to the lungs and the respiratory system; therefore post-operative chest infections and persistent coughs are more common among smokers. Coughing episodes can cause bleeding deep in the tissues that have been freshly operated on and can result in haematomas that delay healing, cause discomfort and may affect the quality of the scarring.

It is also a fact that long-term smoking causes narrowing of the skin’s blood vessels. This can result in reduced blood supply to the skin which explains why a long-term smoker’s skin looks older than a non-smoker’s skin.

In order to minimise complications in the post-operative period we recommend not smoking for four to six weeks prior to surgery and not re-starting until at least four weeks following surgery, if at all!

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