Top Sydney Plastic Surgeon Dr Kernohan explains how Smoking and Nicotine Impacts Your Plastic Surgery Recovery and Results
- Are you a smoker and considering plastic surgery?
- Worried that smoking can influence the results of surgery?
- Interested how is the recovery period if you smoke?
Smoking is a lifestyle choice and is generally regarded as a bad habit. Numerous medical studies show that smoking is terrible for your health, and it is made apparent with the pictures on the cigarette boxes when you buy them.
Smoking when you think of undergoing plastic or cosmetic surgery is even worse as your body is going through physical trauma and needs every resource to heal and repair itself. But nicotine in the bloodstream interferes with that and can result in significant complications, which can give you a poor result from your cosmetic surgery procedure.
Why is Quitting Smoking Before Surgery Important?
Quitting before your surgery is important because that’s how you can ensure the best results from your surgery. There have been many pieces of research and studies performed on the effects of smoking on your body as it tries to heal from surgery. All of these studies have reached the same conclusion that smoking and surgery don’t go well together. The healing process is delayed, specific complications might occur and the recovery takes longer.
JAMA performed one such study, and it aimed to compare risks of complications after the surgery amongst smokers, former smokers, and nonsmokers. For former smokers, they selected only participants who had given up smoking at least a year before surgery. When comparing smokers and former smokers, it was found that 17 percent of the smokers were more likely to die post-surgery, and 53 percent of the smokers had a higher risk of developing major heart or lung issues.
Top Reasons to Quit Smoking
Similarly, a meta-analysis was performed on other studies that focused the effects of smoking and surgery. The meta-analysis results showed that smoking affects different types of surgeries differently, but the end result almost always is necrosis and wound dehiscence. This is because nicotine decreases blood flow significantly, which can produce detrimental results in digit reimplantation during hand surgery. The success rate of digit or finger reimplantation in smokers compared to nonsmokers was found to be approximately 61 percent and 97 percent, respectively. This is a huge difference that needs to be taken into consideration, and it explains why quitting before surgery is a mandatory requirement.
4 Main Reasons to Quit Smoking before Surgery
There are three main reasons that will further make you consider quitting as they explain what happens to your body if you are a smoker and undergoing surgery.
1. Increased complications with anaesthesia
Your lungs have undergone significant changes and are harmed by your smoking habits. This makes the work of your anaesthesiology team even harder as they might have to work around the clock to make sure you are breathing while you are under the effects of the anaesthesia. To ensure proper breathing, your anaesthesiology team might need to use medications that will open up your lungs even more to allow more air to pass through, known as bronchodilators. The use of these medications along with anaesthesia can increase the risk of developing side effects associated with anaesthesia.
2. Increased stress on the heart
Smoking generally puts pressure on your heart and compromises its ability to function properly. The heart can become weak and will need to work even harder during the surgery and after the surgery to ensure proper blood flow to the rest of your body. However, nicotine in the bloodstream makes it difficult to do so. According to recent research, smokers have a higher risk of having a heart attack or other heart complications after surgery compared to nonsmokers. They have 77 percent higher chances of having a heart attack during the recovery period.
3. Risk of getting a blood clot
Smoking also affects the consistency of your blood, making it thicker than usual. This makes it easier for your blood to clot, which can get stuck in any blood vessel causing further complications.
4. Delayed wound-healing
As mentioned above, nicotine in your bloodstream will reduce the blood flow through your body. This in itself is harmful to your body, but when combined with the fact that there is an open incision that needs healing, which is mostly dependent on proper blood flow, the results can be disastrous.
Your tissues also need oxygen to heal properly. There is a higher concentration of carbon monoxide in your body if you smoke. This carbon monoxide reduces your tissue’s ability to receive enough oxygen. As a result it can further slow down the wound healing process, often resulting in wound dehiscence.
What Happens When You Quit Smoking
After your last cigarette, your body goes through changes to repair the effects of nicotine and tobacco on your body. Within eight hours, your blood pressure and heart rate will begin to return to normal, healing themselves. After twelve hours, the level of nicotine and carbon monoxide will reduce in your body. While it takes nicotine around one day to three days to be virtually untraceable in your bloodstream, its levels begin to gradually decrease within twelve hours of your last cigarette.
After a week of quitting smoking, your lung function will begin to improve. You will be able to clear out the mucus build up often seen in smokers. Your lung function will improve to the level of them being less reactive by the second week. This can help you breathe easier during the surgery. Three weeks after quitting, your body’s blood flow will improve significantly, hence, improving its ability to heal wounds.
FAQs about Smoking and Plastic Surgery
Can I have plastic surgery if I smoke?
- You can undergo plastic surgery if you smoke; however, you will need to quit smoking at least four weeks to eight weeks before your surgery. You will also need to remain a nonsmoker during the recovery period. This usually lasts for four weeks to six weeks.
When should I stop smoking before plastic surgery?
- It is recommended that you stop smoking four weeks to eight weeks before the surgery.
What happens if you smoke and have surgery?
- Smoking, in general, is not good for your health. Undergoing surgery and not quitting smoking before that can increase your chances of side effects. Adverse reactions to anaesthesia are more likely to occur during the procedure. Smoking during the recovery period increases your risk of infection. This can result in permanent visible scarring or wound dehiscence. Smoking also reduces the blood flow in your body, which is important for skin repair and wound closure.
Can you be denied surgery if you smoke?
- While smoking is a personal decision, patients may be denied surgery if they smoke in some cases. The medical complications can be severe and there is an increased risk of getting unsatisfactory results. This is why it is important to stop smoking before the surgery.
Why does nicotine affect surgery?
- Nicotine affects the blood flow in your body, as it constricts the blood vessels to the point that your skin and incision site may not get enough blood to heal properly. Moreover, smokers have reduced lung capacity, which increases the risk of side effects associated with anaesthesia.
Can I get a boob job if I smoke?
- The recommendation is to quit smoking at least four weeks to eight weeks before the boob job. Being a nonsmoker is one of the eligibility criteria for the surgery. This means that being a smoker could result in you not being a suitable candidate for the procedure.
Can I get a facelift if I smoke?
- To reduce your risk of complications and side effects associated with the surgery, patients should quit smoking at least four weeks before getting a facelift.
What happens if I don’t stop smoking before a tummy tuck?
- Smoking before the tummy tuck procedure or during the recovery period is not recommended. It reduces your skin’s ability to heal and can even lead to the death of skin cells, known as necrosis. Both of these scenarios are not preferred. They can result in visible and permanent scarring, which defeats the purpose of a cosmetic procedure.
Will your nipples fall off if you smoke?
- If you have chosen to undergo a breast lift procedure and you are a smoker, then the most important complication that can occur is skin or nipple necrosis. The lack of proper oxygenation in the blood can lead to nipple or skin necrosis in smoking patients undergoing breast surgery.
How long does it take for nicotine to leave your system?
- Nicotine leaves your bloodstream approximately one day to three days after your last cigarette. It becomes virtually undetectable in your urine three days to four days after your last cigarette.
Can a surgeon tell if you smoke?
- A surgeon can ask for a nicotine test to ensure that you are a nonsmoker before the surgery. The immediate results of the test will let the surgeon know if you smoke.
What happens if I don’t tell my doctor I smoke before surgery?
- This is not recommended as some risks and complications have a higher probability of occurring if you are a smoker. These can compromise the results of the procedure and can even be life-threatening in some cases. Your surgeon will suggest you quit smoking so you can undergo the surgery of your choosing.
How do you get nicotine out of your system before surgery?
- Nicotine stays in your bloodstream for one day to three days after your last cigarette. You can help clear the nicotine out of your system by drinking plenty of water, exercising and sweating out the toxins, and eating foods rich in antioxidants. This is most likely not necessary as you will have to quit at least four weeks before your surgery, and nicotine will have cleared out by then.
When can you resume smoking after surgery?
- You can resume smoking after your recovery period is over, which, for plastic and cosmetic surgery procedures, lasts for approximately six weeks.
Can I vape before surgery?
- You cannot vape before surgery either, as any form of nicotine consumption will produce the same side effects as cigarettes.
Can I smoke E-cigarettes before surgery?
- Smoking e-cigarettes before surgery is not recommended as they contain nicotine which can have an effect on your surgery results.
Further Medical Reading on Smoking and Surgery
Resources to help you Quit Smoking
Dr Michael Kernohan – Specialist Plastic Surgeon in Sydney NSW
Dr Michael Kernohan is a Sydney Plastic, Reconstructive and Cosmetic Surgeon providing a wide range of services from skin cancer to cosmetic surgery for the face, nose, breast and body.
He also offers complex reconstructive procedures following trauma and a range of cancer treatments using the most innovative and up-to-date treatment options.
Dr Kernohan is able to care for both public and private patients and currently has appointments in five Sydney hospitals and has an additional leadership role as Director of Surgical Specialities.
His main clinic is now located in Gregory Hills and he has 4 other locations – Bowral, Liverpool, Surry Hills (city) and Campbelltown Clinic – servicing patients in Sydney Southwest and Southern Highlands.