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Smoking and complications

Smoking and complications

Smoking leads to more complications with Plastic Surgery

Cigarette smoke has a negative influence on the blood flow in the skin and fatty tissue. The carbon monoxide decreases the oxygen level, the nicotine cramps the arteries and it relaxes the veins. This means that there is less supply of oxygenated blood and the low-oxygen blood is drained less efficiently. This may cause a slightly purple-toned skin. It is more common for smokers to suffer from bruising.


With plastic surgery the skin and the subcutaneous fatty tissue is detached from the underlying layer, moved and tightened. Blood vessels are cut in the process of detaching, which forces the blood to take a bypass to reach the skin. This is especially the case with breast lift, breast reduction, abdominal wall correction, facelift and the forehead lift. Because the blood needs to travel a longer distance, the blood flow in the wound edge decreases and the skin near the scar could die off as a result from that. This manifests itself in wound infection or slow recovery.

My advice

Stop smoking at least 4 weeks prior to surgery. Nevertheless will the abovementioned treatments carry a certain risk for heavy smokers, because the negative effects will not have fully disappeared within this time frame. With surgery this can be taken into consideration by being prudent in disturbing the blood flow in the skin and fatty tissue. If this alternative technique will be of influence on the final result, that will be discussed with you prior to surgery.

It is of the utmost importance to be honest and to admit if you are unable to fully refrain from smoking during the 4 weeks prior to treatment. Then it can be determined if the risk of complications is too substantial to move forward with the surgery.

Dr. Erik J.F. Timmenga

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