-Mark Twain
Smoking is a strange phenomenon with a long history in human society. Although Gaspare Tagliacozzi might not have been introduced to tobacco (it was brought to France by the Frenchman Jean Nicot in 1560), he was surely familiar with the practice of smoking.
Smoking various mind-altering or hallucinogenic substances had been done for thousands of years. In ancient India, China and the Middle East, opium and cannabis were smoked through pipes for religious rituals and eventually for pleasure. Since early in Christian rituals, Greek Orthodox Christians burned incense during their services, not to get high, but because of the …show more content…
It’s bad for your lungs, your cardiovascular system, and can lead to cancer. Smoking and its ill effects are of particular concern to plastic surgeons, perhaps more than any other type of surgeon. Tagliacozzi would have been intrigued to learn that the substance people intentionally inhale for pleasure or habit, has profound effects on wound healing. Certain procedures like facelifts and tummy tucks could end up in disaster if performed on an active smoker.
Nicotine constricts blood vessels, and a few small blood vessels are all the skin of some flaps (or sections of skin and soft tissue) in plastic surgery procedures depend on for life-giving oxygen. Constrict too many of those little vessels, and your skin flaps can die. I’ve seen it many times, usually in patients who lie about not smoking or those in which an urgent procedure is needed and we can’t afford to wait for them to quit smoking for 6 weeks before …show more content…
A lot of the skin edges near her incisions on the right breast began turning dusky and eventually black. A lot of the skin died, and she also suffered fat necrosis, or death, in that breast which required two surgical debridements before we were left with tissue healthy enough to heal itself. For unexplainable reasons, the left side healed fine.
Why did this happen? It was quite clear to me and my staff that Kelly had resumed smoking right after her surgery (or maybe even never fully quit). She reeked of smoke at every post-op visit and blamed it on her chain-smoking mother who rode with her to the visits. Second-hand smoking is bad enough to have caused her complications, but my hunch is there was some first-hand smoking involved as well.
Another patient named Cindy was a boisterous Vietnamese lady who had been saving for a tummy tuck for years. In fact, she stopped by my office and made payments towards the procedure for many months until it was all paid up. The problem was her smoking and the fact that she had not yet quit as we had planned. I warned her that I would be administering a urine nicotine test on the day of her pre-op history and physical exam and she would not be able to fool