How does marijuana smoke interfere with wound healing and plastic or cosmetic surgery
One of the most important factors in a wounds ability to heal is the oxygen content of the tissue.
Anything that interferes with oxygen delivery to a wound can impair wound healing.
If I can provide an oversimplified analogy. Plants require water to grow. Interfering with the water supply can compromise plant growth i.e., "you can't grow roses in the desert" is my saying.
The carbon monoxide in any smoke (tobacco or marijuana) plus the particles in the smoke can interfere with the lungs ability to oxygenate the blood. IF the blood is not oxygenated, then the wound will not reciev sufficient oxygen to assure uncomplicated healing.
Marijuana and wound healing
Although it does not have nicotine in it as cigarettes do (which acts as a constrictor), it does affect the oxygenation of tissue. During the healing process, oxygenated tissue will heal faster then those with less oxygen. Smoking can lead to increase wound breakdown, infection and open wounds. The amount that you smoke will affect healing but for elective surgery you should stop altogether to reduce your risks of complications after surgery. Although Marijuana is used to help increase appetite as well as decrease some side effects of chemotherapy, it still has a negative effect on wound healing.
Here are the major points of smoking Tobacco or Marijuana before or after surgery:
1. There is nicotine in tobacco, but not in marijuana. However, most joints are rolled with marijuana and tobacco combination. Nicotine is a vasoconstrictor that decreases blood flow to the tissues. This is the major problems that can cause a very bad outcome in some surgeries. In a breast augmentation, there is not a lot of risk as there are not a lot of incisions which decrease blood flow to the tissues. In a breast lift or tummy tuck, on the other hand, there is much longer and more involved incisions. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die. This can cause part of the breast or nipple, or in the case of a tummy tuck, part of the belly tissue to die, resulting in a very bad outcome. This is especially bad in breast reductions or face lifts. In a rhinoplasty the tip of the nose and the columella, the area between the tip and the lip, is at risk. Your skin and tissue can turn black and fall off if this happens. Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion. Vaporizers do not decrease the amount of nicotine in tobacco, only decrease the smoke. Hookah also does not decrease nicotine.
2. There is carbon monoxide in both tobacco smoke and marijuana smoke. Carbon monoxide decreases the oxygen carrying capacity of hemoglobin in the blood. This is different from the vasoconstrictor effect, but has the same result of having the risk of tissue death in conjunction with surgeries that decrease the blood flow to tissues such as breast lifts and tummy tucks, as opposed to an augmentation alone that does not decrease blood flow to as great of an extent. Again, edible forms of marijuana do not have smoke, and thus carbon monoxide poisoning.
3. Coughing. Both tobacco and marijuana smoke disrupt the lining of the lungs and bronchi and can lead to coughing episodes. Coughing episodes can lead to internal bleeding after surgery that can lead to hematomas and complications, and again a bad outcome. Again, edible forms of marijuana does not have this effect.
4. Anesthesia effects. Marijuana can have drug interactions with certain anesthetic drugs. Thus it is important to tell your anesthesiologist about your marijuana use.
In conclusion, Smoking, whether it be tobacco or marijuana, is detrimental to your surgery outcome. Edible marijuana is much less so, but be honest about your use with your surgeon and anesthesiologist so that you can have the best outcome. In general, you should quite smoking many weeks, ideally 6 weeks before surgery, and not smoke for at least 2 weeks after surgery.
Pablo Prichard, MD
Don't allow your tummy tuck to go up in smoke
I think that you have gotten great advice from the other surgeons that I agree with. The main issue is the hazardous effects of smoking and healing of your tummy tuck incision. The last thing that you and your surgeon want to deal with would be an abdominal wound. It is preferable to stop smoking so that you can have the best outcome possible.
It's well established that one tobacco cigarette reduces tissue oxygen levels for up to 4 hours and repeated smoking will result in wound healing problems. The reasons for this is mostly related to the vascular constriction caused by the nicotine. However, because there are over 100 other chemicals in cigarettes the exact one or ones that result in wound healing problems hasn't been determined.
There aren't any studies that have looked at the effect of THC on wound healing. There tend to be less additional chemicals in marijuana so it may be less detrimental but this is only speculation.
Effect of Marijuana on healing is largely unknown
Marijuana probably has a negative effect on wound healing for the reasons the others have noted. This has not been studied though. Suffice it to say that it should be curtailed to decrease its possible risk to healing of the wound.