After careful examination of the scientific literature, I was able to find the following to have deleterious effects on wound healing and wound repair:
1. Nicotine is a vasoconstrictor that reduces nutritional blood flow to the skin, resulting in tissue ischemia and impaired healing of injured tissue. Vasoconstriction means constriction of blood vessels, namely arteries that supply nutrients and oxygen to our tissues. Less blood flow means less oxygen and nutrients to the tissue that are trying to repair the injury. Less oxygen and nutrients means that there is an increased likelihood for wound infection and subsequent scarring.
2. Carbon monoxide diminishes oxygen transport and metabolism in injured and healthy tissue. The carbon monoxide competes with oxygen on the 'oxygen transport molecule', also known as hemoglobin. So, instead of oxygen delivery by the hemoglobing molecule, carbon monoxide is delivered to the tissue. Unfortunately, carbon monoxide has tight binding to the hemoglobin molecule and is less likely to be replaced by oxygen.
3. Hydrogen cyanide inhibits the enzyme systems necessary for oxidative metabolism and oxygen transport at the cellular level. These enzyme systems are important for the metabolism of oxygen at the level of the tissue where there is need for this oxygen for critical tissue repair and wound healing. After surgery, wounds are in constant flux and healing continues for weeks. As a matter of fact, wound remodeling continues for 6 months after a surgical incision is made and therefore, smoking in general should be prevented during this critical time period. Practically, however, most patients resume smoking after surgery.
4. Smokers have a higher incidence of unsatisfactory healing after face-lift, rhinoplasty (nose job), blepharoplasty (eyelid surgery) and breast augmentation.
5. Smokers should be advised to stop smoking 3 weeks prior to elective cosmetic surgery or any traumatic injury requiring reconstructive surgery. If at all possible, do not smoke for at least 4 weeks after surgery.
So, if you are deciding to have plastic or reconstructive surgery, stop smoking for at least 3 weeks before surgery and 4 weeks after surgery. This will improve your likelihood of a successful procedure with optimal wound healing conditions.
