If you were to search through a website such as RealSelf.com, a plastic surgery site where doctors candidly answer patient questions, you would quickly notice a trend in how most surgeons feel about smoking and its effects on surgical results. Surgeons from across the 50 states are quick to point out how smoking can complicate procedures and mar outcomes. Many doctors report that they’ve seen smokers who did not follow their surgeons’ instructions to quit end up back on the operating table.
Smoking can be particularly damaging to patients who get procedures of the face, an especially delicate area of the body. The circulatory system in the skin is very fragile, and our skin gets vital oxygen through t
Smoking Cessation Can Make a Facelift Look Better
iny veins and capillaries running throughout. In smokers, an unusually large amount of carbon monoxide runs through those veins, but the skin usually still gets enough oxygen to live healthily. When a person gets a facelift, though, where flaps of skin are cut away and the remaining skin is reattached, the skin’s circulatory system can be damaged. And if that patient is a smoker, that damage is amplified, and the skin’s flow of oxygen is greatly reduced.
Facelift surgeons and other doctors have been warning smokers of these effects for many years, but they still report patients who just won’t quit. Some ask whether nicotine patches or gums can help them cut back before surgery, but doctors warn against it; nicotine is a vasoconstrictor and narrows the blood vessels, reducing the blood flow to the skin in a way that could be harmful in delicate facial procedures.
Doctors say many patients lie about their smoking habits and pre-surgery cessation when they go in for a facelift consultation. Some try to quit just before surgery, but this often means toxins are still in their system and they cannot handle the post-surgery smoking restrictions. Patients are generally told not to smoke for 2 to 4 weeks after surgery, but the addiction gets the better of many, and they light up too soon. As a result, scars can be more noticeable, chances for complications are greater, coughing during healing can create disruptions and bleeding, and the lack of oxygen to the skin can damage (or even kill) the tissues. The results are not ideal.
Many of these disruptions in the healing process can be corrected with a revisionary facelift, but these procedures carry an extra list of possible complications and considerations. Many surgeons openly say they would prefer to see their patients quit smoking and see the desired result the first time than see them back on the operating table for revisionary work.
Thankfully, things are looking better for plastic surgeons in Orlando, Florida, thanks to a voter mandate from 2007. Florida has a statewide cessation effort and to date has directly helped 72,000 Floridians quit smoking. In a state where plastic surgery is common, this is great news for surgeons. Cities such as Orlando, in Orange County, showed only 13.3 percent of adults were smokers in 2010, dropping the number of patients who would likely require a revisionary facelifts and other procedures.