How Smoking Affects Plastic Surgery Results

If you frequently read cosmetic surgery blogs or have had some work done yourself, you are probably aware that nearly much every surgeon out there will tell you to stop smoking before having a cosmetic procedure done. Whether you are a pack-a-day smoker yourself, have never touched a cigarette in your life, or lie somewhere in between, you have probably wondered why it’s such a big deal. What, you may ask yourself, does smoking have to do with cosmetic surgery?

Smoking Affects Plastic Surgery

The answer is pretty simple: blood.

When we are injured – or cut open for surgery – our body heals the wound through an automatic, natural process that relies almost entirely on our blood’s ability to bring oxygen and much-needed nutrients to the wound site. When this happens efficiently, the wound heals free of infection and minimal scarring occurs. When this process is interfered with, say by picking off your scabs, the process is slowed and the risk for infection increases greatly. Scarring also worsens the longer a wound takes to heal.

But what does all this have to do with smoking? Put simply, it makes our blood less efficient.

The nicotine in tobacco products is part of what gives it that feel-good buzz, and also part of what makes it so addictive. It is also, unfortunately, quite bad for our blood. By binding with blood cells, it prevents the blood from carrying as much oxygen and nutrients. This means that it takes longer for the same amount of oxygen to reach your muscles and tissues and is also part of the reason why heavy smokers so often need to stop and catch their breath: it’s not just that their lung function is impaired, but also that their blood is not carrying as much oxygen as it could around the body.

But why cosmetic surgery specifically?

During your cosmetic procedure, not only is your surgeon creating an incision, they are also likely to be moving tissues around in different ways. This can cause damage to the blood vessels, interrupting some of the blood flow to the affected area. When this happens, blood flow to the incision site and healing tissues is already reduced, making it even more dangerous to have nicotine-laden blood that cannot efficiently bring oxygen and nutrients to the site.

Other Complications

Blood efficiency aside, there are several other potential complications that can arise when you combine smoking with surgical procedures:

  • Extra anesthesia:
  • A study completed by the European Society of Anesthesiology found that smokers required on average 33% more anesthesia than non-smokers. Not only does this raise costs, it also increases the risks associated with being placed under general anesthetic.

  • Extra pain medication:
  • In addition to requiring more anesthesia, smokers also require additional pain medication during their recovery period, up to 23% more according to that same Society of Anesthesiology study. Even second-hand smokers typically require extra anesthesia and pain medication during their procedures and convalescence.

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