How long do I have to quit smoking for?

It’s well known that smokers have more surgical complications than non-smokers.One of the most frustrating complications for plastic surgeons is called flap necrosis. This is where part of the skin can literally turn black and die, following surgery on the area. If that sounds bad, you’re right. And it’s much, much more likely in smokers, even those who only smoke a few cigarettes each day. It’s especially a problem in plastic surgery operations where large skin flaps are elevated – facelifts, breast lifts and tummy tucks, to name a few.

This month, a new study published in Plastic & Reconstructive Surgery, looked at the risks of flap necrosis due to smoking, trying to scientifically determine the right amount of time needed for a patient to quit smoking prior to surgery. The investigators used an animal model, with a standardized design of skin flap, and had various smoke-free intervals prior to skin flap surgery, keeping track of the amount of skin necrosis in each group.

Their results:
1) Even at 8 weeks smoke-free prior to surgery, the ex-smokers had bigger zones of flap necrosis (=bad!) than the non-smoking control group.

2) Increasing duration of being smoke-free was significantly correlated with decreased amounts of flap necrosis. In other words, the group that was smoke-free for only 2 weeks did worse than the group that was smoke-free for 8 weeks.

Take home message: Please don’t smoke for at least 8 weeks before your tummy tuck, facelift, or breast lift surgery. If you smoke and have a wound healing complication, you really have no one to blame but yourself. It’s wiser to postpone your surgery if you can’t quit.

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