David B. Reath, MD
Knoxville, TN (865) 450-9253

Little Known Fact: Cigarettes Hinder Healing From Surgery

Smoking and Plastic Surgery
Recently a patient asked me to blog about the effects of cigarette smoking on surgery and healing from surgery. Although she knows that cigarette smoking is bad for you, and that you should stop, she wanted to know more about why this was so important, and what the effects are. This is a very reasonable request and thus this blog entry.

Lung Cancer Isn’t The Only Problem
Most people know that smoking is bad for you. And most people know that this can affect your lungs by making you susceptible to lung cancer and emphysema. But what many people don’t know is the other more important side effect of smoking: circulation problems. Not everyone who smokes will develop lung cancer, but everyone who smokes will have their circulation negatively effected.

The culprit here is nicotine. Nicotine is a very potent vasoconstrictor. This means that it causes the blood vessels to squeeze down so that blood will get through. This is not good for your heart, your brain, or even your skin. Healing after surgery depends upon the blood getting to and through the blood vessels in your skin. If the blood vessels are constricted, there is diminished blood flow. This can cause wounds not to heal, and for segments of the skin to die. This, then, creates a big problem which can lead to permanent scarring, prolonged recovery, and the need for other operations.

At Least Quit Smoking Temporarily
The next question is how long should one stop smoking if surgery is planned. There is no real good answer to this, but three to four weeks seems to be a minimum. This will not remove all the effects of smoking, but it will improve the situation. Ultimately it’s best not to smoke at all, or to have quit for several months or years.

Gum, Patches, And Second-Hand Smoke
There are two other considerations. Remember, it’s nicotine that is the problem. So using a nicotine patch or chewing nicotine gum may help you to quit smoking, but you are still introducing nicotine into your system. And, second-hand smoke can also deliver nicotine to your body. It’s best to be in a smoke free environment.

When you are considering elective surgery you should do everything to insure a good outcome and limit complications. Smoking cessation is a very important step to take to make sure we have the best result.

All the best,

David B.

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