How Does Smoking Affect Healing and Scarring After Plastic Surgery? Doctor Answers, Tips
Plastic Surgery: Q&A
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How Does Smoking Affect Healing and Scarring After Plastic Surgery?

I'm a smoker. They (any facial surgeon) say you MUST quit smoking 2-6 weeks before and I'm having a real problem. I went from 20 to 24 cigs. a day down to 2 and still its a problem. Perhaps someone could elaborate on the why and how it effects the healing process, scaring whatever. Thank you.

4 Doctor Answers | Asked by jacko in STUART, FL
+7

Quit Smoking and Remember, "You're a Puff Away From a Pack a Day!"

Smoking is thought to retard wound healing through impairing tissue oxygenation (the good, wound healing fresh air "oxygen"), and relative hypoxia (too low of a level of oxygen) may also cause a sluggish neutrophil response to pathogens (which in English translates to your white blood cells are slowed way down and cannot fight the bad guys, bacteria that cause infection). This also leads to very poor wound healing. Face lift patients have had their cheek skin slough due to poor... more
+5

Smoking and Surgery

I agree with the answers listed below but would like to elaborate on other issues with smoking. For wound healing there are actually two factors. First - Nicotine causes blood vessel constriction, reducing blood supply to the skin. When we perform surgery the incisions we leave reduce normal blood flow. We count on the remaining blood supply that we haven't cut to keep skin and soft tissue alive. Smoking works directly against this. Second - Smoking also causes small vessel damage (which... more
+5

The problem with smoking and facelift surgery is that...

The problem with smoking and facelift surgery is that the nicotine constricts the blood vessels that are critical to keeping your lifted skin alive as you heal from surgery. Inadequate blood flow will lead to skin death, with the skin turning black and sloughing off leaving substantial scars on your face that are permanent. The nicotine is the culprit, not the actual smoke so nicotine gums and patches are equally bad. A period away from all nicotine of one month before AND another month... more
+3

Smoking and Facelift Surgery

Much of my objection to smoking has been well covered by the previous answers.  One of the major acute  problems with active smokers is the carbon monoxide affect (from smoking) on oxygen carrying capacity in the blood stream.  This adversely affects recovery on a variety of levels, most specifically wound healing. Therefore, a non-smoking period of at least 2 weeks, but preferably 6 weeks is required. The major chronic problem with smoking is that Nicotine... more
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Comments (1)

bkinmn 14 Dec 2012
The need for second opinions from MDs is important for this reason: no single doctor's opinion should be taken as full authority. When speaking of the effects of smoking on healing, an important distinction must be made: smoking's effect on healing and nicotine's effect on healing. These are vastly different considerations. Contrary to Dr. rand's opinion below, which you'll notice contradicts itself quite nicely. Smoking is the culprit when it comes to healing, NOT nicotine. Sorry Dr. Rand, notine is not as harmful by itself as your review might lead readers to believe. Carbon monoxide, tar, and thousands of other chemicals found in cigarette smoke impede the blood's ability to carry oxygen and repair damaged tissue. I'm making no claim as to the harm or benefit of nicotine on the body's healing process. However, I have studied medical journals on the topic extensively out of personal interest. I am not even an MD. But I am a former smoker. Make sure when you receive important medical advice to always seek a second independent opinion.

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