Smoking, Secondary Smoke, and Healing

All procedures in plastic surgery are performed to improve form and in cases function. Our goal as plastic surgeons is to achieve improvement with minimal scarring. Unfortunately, smoking and secondary smoke affect would healing in a potentially devastating way. Please be honest about your exposure to smoke so we can take good care of you and prevent problems and complications with your procedure.

Here are some online resources about the health risks of smoking and information about how to quit smoking:

Any exposure to smoke whether directly or indirectly can result in poor wound healing, delayed wound healing, skin loss necessitating skin grafting, increased risk to wound infections, and loss of skin and deeper tissues, all resulting from decreased blood supply to the areas. The diminished blood flow to skin wound edges can cause the breakdown of skin and scabbing, which will adversely affect the quality and character of the scarring (there is an increased risk of hypertrophic or keyloid scarring). This is true for any surgical procedures requiring incisions (even skin lesion removal and liposuction).

The following is a partial list of cosmetic procedures and the impact smoking or inhaling second hand smoke may have on wound healing. It is not intended to be a complete list of procedures or list of all possible complications.

  • FACE LIFTS – There can be actual skin loss of the face in front and behind the ear.
  • BREAST IMPLANTS (Reconstruction, Tissue Expanders, and Augmentation) – There is an increased risk of delayed wound healing, capsular contracture, and implant infection with the possibility of extrusion.
  • BREAST REDUCTION AND BREAST LIFT (MASTOPEXY) – There can be delayed would healing resulting in unsightly scarring and skin loss and potential nipple loss necessitating skin graft. In all cases of patients exposed to smoke or directly smoking, wounds do not heal in the normal length of time. Wound healing can be prolonged as long as 3-4 months.
  • FOREHEAD LIFT – There can be hair loss, poor wound healing, and scarring.

Slow wound healing (months instead of weeks), skin loss resulting in scabbing and prolonged need for dressing changes and infection usually involving the need for antibiotics (but sometimes another surgery to drain the infection) are all complications that can occur if you smoke or are exposed to second hand smoke.