Why Do I Have to Stop Smoking Before My Tummy Tuck Surgery?

It’s a question we hear a lot.  When prospective patients call our Fort Worth plastic surgery office to schedule an appointment to be seen for a tummy tuck, we ask a few questions.  One of the most important questions is “Do you smoke?”  The answer to this question determines if you’re a candidate for a tummy tuck.  Why is that?

Woman Smoking We actually ask the ‘smoking question’ to all patients who are considering cosmetic surgery.   By now, everyone has an idea that smoking is not good for a person’s health.  The more a person smokes, and the longer she has smoked, the more potential harm has happened to her body.

Not all cosmetic surgery procedures are created equal.  Some operations, like breast augmentation, require small incisions.  Breast augmentation does not affect circulation to the breast tissues very much.  When a person is otherwise healthy, we don’t really worry much about smoking in operations like this.  Other cosmetic procedures, however, do affect circulation quite a bit. Operations like tummy tucks, facelifts, breast lifts, and breast reductions change blood flow in the tissues.  That’s where smoking comes becomes important.

Smoking affects circulation.  It affects the tiniest of blood vessels the most.  Blood vessels in the heart, lungs, brain, and eyes have all been shown to be affected by smoking.  Passive exposure to smoke has similar effects.

Studies have shown that tissue oxygen levels are decreased in smokers.  Cells that are necessary for good wound healing are impaired.  Some of these circulating cells don’t even make it to the wound site.  The ones that do make it don’t work correctly.  Collagen synthesis is decreased.

A Google search of ‘smoking’ and ‘surgery’ shows all of these things.  Wound complications, general infections, pulmonary complications, and neurological complications are all more common after surgery in people who smoke.

An interesting study from Scandinavia was published in 2019.  They looked at patients who planned to undergo weight loss surgery.  For the three months leading up to the surgery, the patients were told on multiple occasions not to smoke.  When the day of surgery arrived, urine tests were done on all of the patients to see if they had indeed stopped smoking.  They found that 13% of the patients  had not stopped smoking.  When confronted with the test results, they admitted they had continued smoking.  The knew that smoking increased their risks, they knew that their surgery would be canceled if they continued smoking, but they smoked anyway.

So, when patients call our Fort Worth plastic surgery office, we ask about smoking.  If they are hoping to undergo tummy tucks, facelifts, breast lifts, and breast reductions, we will not see them in the office until they have stopped smoking.  It’s not because we don’t like them or don’t want them in the practice.  It’s because we care about their safety.  We want them to get the best result in the safest way possible.

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