Just about everyone knows that smoking is bad for you. But it is easy to ignore just how bad it can be. Particularly for long term smokers who are planning a cosmetic procedure. The truth is, there are very few things that can increase your risk for complications more than smoking. Here’s why.
Healing requires getting lots of oxygen to the healing tissues. Smoking affects your body’s ability to heal in three different ways. First, cigarette smoke has tar in it that gums up the surfaces of your lungs. This reduces the area that your lungs can use to work effectively. Basically it blocks the channels needed to get oxygen into your body and get carbon dioxide out.
Second, while we are talking about the gases you breathe lets discuss carbon monoxide. You may have heard about people committing suicide by starting their car in a closed garage. How that works is the accumulation of carbon monoxide from the exhaust fumes. When you breathe carbon monoxide it gets into your lungs just like oxygen would. In fact it attaches to the same place on your red blood cells that oxygen does. The problem is that it never lets go. Typically every molecule of hemoglobin in your red blood cells is able to carry four molecules of oxygen. Once carbon monoxide attaches to hemoglobin it as there forever, until that red blood cell is replaced by a new healthy one. That can take many weeks. So people breathing in car fumes slowly reduce their ability to carry oxygen to their body until they can’t carry enough to survive. Smokers are doing this very, very slowly, one cigarette at a time.
And last, the nicotine in cigarette smoke has a bad effect on the little arteries that carry oxygen to healing tissue. Nicotine causes them to shrink down in size. Imagine a normal sized artery being the size of rigatoni pasta. When nicotine is around that rigatoni shrinks down to the size of angel hair pasta. As you might imagine, the much smaller artery (capillary) can’t carry enough blood (carrying oxygen) to the healing tissue under the effects of nicotine.
Continuing to smoke leads to lots of big problems including trouble healing, infections, wounds opening up, loss of skin, and lots more. It is particularly dangerous in the case of abdominoplasty (tummy tucks) or facelifts where the skin is really stressed by the procerure and needs lots of oxygen to heal. Patients that have those procedures and continue to smoke can lose big pieces of skin that can turn black and fall off.
No matter what procedure you are planning, smoking is a very bad idea. In my practice I recommend that patients stop smoking two weeks before surgery and refrain from smoking for up to four weeks after surgery. At that point many patients have simply quit forever. If you are planning a cosmetic procedure and are a smoker you need to get the smoke out!
