We are emphatic about patients not smoking prior to undergoing a procedure at the North Shore Center for Facial Plastic & Cosmetic Surgery. We all know that not smoking is good for overall health, but did you know that smoking increases the risks of problems with wound healing? This holds true for all cosmetic surgery procedures performed at the clinic. These procedures involve complex wounds. The body's own mechanisms must function optimally to repair and heal. According to the U.S. Centers for Disease Control and Prevention (CDC), 2004 Surgeon General's Report, “The evidence is sufficient to infer a causal relationship between smoking and increased risks for adverse surgical outcomes related to wound healing and respiratory complications.”

The documented effects of the toxic constituents of cigarette smoke—particularly nicotine, carbon monoxide and hydrogen cyanide—suggest potential mechanisms by which smoking may undermine expeditious wound repair. 

• Nicotine reduces nutritional blood flow to the skin, resulting in impaired healing of injured tissue. Nicotine also increases platelet adhesiveness, raising the risk of thrombotic microvascular occlusion. In addition, proliferation of red blood cells, fibroblasts and macrophages is reduced by nicotine.
  
• Carbon monoxide diminishes oxygen transport and metabolism.
  
• Hydrogen cyanide inhibits the enzyme systems necessary for oxidative metabolism and oxygen transport at the cellular level.

Slower healing has been observed clinically in smokers with wounds resulting from trauma, disease or surgical procedures. The reduced capacity for wound repair is a particular concern in patients undergoing cosmetic or plastic reconstructive surgery. Compared with nonsmokers, smokers have a higher incidence of unsatisfactory healing after facelift surgeries, as well as a greater degree of complications following breast surgeries.

Should you choose to abstain from nicotine-related products for at least the recommended two weeks before and after your procedure, you will avoid many complications such as poor and/or delayed wound healing, increased risk of infection and longer bruising period.

So, to all our patients considering procedures: please don't smoke two weeks before and two weeks after cosmetic surgery!