How to Help Plastic Surgery Patients Beat Tobacco

Darshan Shah, M.D.

by Darshan Shah, M.D. | August 10, 2010 @ 03:00PM

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Most patients who are arranging a plastic surgery procedure are dimly aware they may have to quit smoking.

While taking the medical history, most plastic surgeons ask if the patient uses any form of tobacco. Usually, the patient is asked to quit two weeks before surgery.

Virtually everybody is aware that smoking is unhealthy. For plastic surgery, the long and short of the story is that smoking damages the blood vessels and complicates recovery. Why?  Nicotine causes the blood vessels to shrink.

Constricted blood vessels obstruct blood supply to the skin. Also, the carbon monoxide contained in tobacco smoke displaces a great deal of the oxygen contained in blood. And because it is oxygen that heals and nourishes a wound -- like a surgical incision -- the smoker delays his own healing.

You must ask yourself why the patients come to the cosmetic surgeon in the first place? To look better. Thus, smokers are actively undermining their own goals and may even look worse after their procedure, depending on how much they smoke.

Here are the other ways smokers work against their own wishes and goals for cosmetic surgery:

Bruises last longerThe skin shrinksHealed incisions look worseYour risk of breathing problems is higherThe chance of infection is larger

Not only are smokers in jeopardy of the above laundry list of undesirable outcomes, so are patients who are merely around smokers.

Exposure to secondhand smoke is almost as bad as smoking itself. Just like a smoker, the surgical patient who has been around smokers and arrives for a procedure presents him-or-herself with constricted blood vessels and a lower level of oxygen in the blood.

Plastic Surgery Patients

"...smoking damages the blood vessels and complicates recovery."

But here's some food for thought: if we physicians are going to ask patients to stop smoking for only several weeks, why not put forth a little more effort and help them give up the habit permanently? When plastic surgery patients permanently stop smoking, they acquire an asset of inestimable value: a healthier lifestyle and a vastly improved quality of daily life.

My personal guidelines are for smokers to stop one month before and three months after their procedure. That's actually a pretty good start on smoking cessation. Moreover, the tools to break tobacco addiction are readily at hand. All that needs to be done is to put it all into action.

Although it may not be in my job description, I decided to jump in and help myplastic surgery patients kick the tobacco habit forever.

Tummy Tuck

Here's what happened with one patient. A 40-ish woman who wanted to get rid of loose skin and excess fat in her abdomen came to me asking about tummy tuck surgery. She had tried diets and exercising many times but did not have good results. Additionally, she had been overweight for years. Both she (since age 15!) and her husband were pack-a-day cigarette smokers. The smoking notwithstanding, she was a good candidate for a tummy tuck.

I prescribed a medication known as Chantix --- to minimize cravings -- for both the patient and her husband while starting them on a psychological ploy in which they would drink a glass of water every time they craved a cigarette. Using the tummy tuck as a carrot, I told her when she had been smoke-free for three months, we would schedule the surgery.

Regular Exercise Routine

Results? Both the patient and her husband stopped smoking, and the patient's surgical incision healed perfectly. The couple also lost weight and that provided the motivation to examine their eating habits even more closely. Both eventually lost more weight by adopting a regular exercise routine. They put the $500 monthly they had been spending on cigarettes into a bank account and eventually bought a new car with it.

Of course, the frosting on the cake was the patient's slender and tighter new waistline. If ever there was a case of win-win-win, this has to be it! 

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