The effects of smoking are well known and documented in literature worldwide. Many plastic surgery patients begin to quit smoking prior to surgery and then resume their daily habit post surgery without think of the harmful effects it may have on the body, the procedure and the long term effects. There is an underlying effect smoking has on people who have undergone plastic cosmetic surgery.
The weathering of one's skin, the lines and wrinkles in the face, and the aging are a direct effect of smoking. Cigarettes have very harmful toxins that combine to create a bad environment for the body to live in. Nicotine causes vasospasms in the vessels of the body. Vasospasms, in simple terms are a contraction of vessels, which cause the narrowing and restriction of blood flow. Carbon monoxide may bind to oxygen and not allow oxygen to be released into the areas that it needs, to areas such as the skin. The effect is the wrinkled and weathered look that so many smokers have. This is very rare in non-smokers, because there is no deprivation of oxygen to the skin. This weathered skin tends to look aged more so than their chronological age. With plastic surgery you can erase those lines and wrinkles, but if one continues to engage in behavior that is detrimental to the outcome, you might ask, why bother?
There is an even more dangerous effect of smoking with surgery. When surgery is involved, when skin is incised and elevated, and its blood supply is decreased temporarily, this may cause a very harrowing situation. In virtually all cases, healthy skin when temporarily disconnected, the decrease in blood supply will be well tolerated. The skin can be elevated, tightened but it must be kept alive- although obvious, it is really the main purpose of plastic surgery. One can see that the effects of nicotine and carbon monoxide described that may take an otherwise healthy skin flap and cause such a decrease in blood supply that may actually kill the skin. If this was to occur, one can get loss of full thickness tissue requiring an increased time in healing or even the use of reconstructive surgery with skin grafting and flaps to correct the deformity. This is not the desired outcome of the cosmetic surgery. Many surgeons will not do an abdominoplasty or a face lift on smokers. Smokers will always have a less satisfactory outcome than non smokers, although they will see some change. Some surgeons may perform procedures that will not require a lot of skin surface elevation, because it will not cause undue trauma, and potential for increased damage. Although there are surgeons who will perform these procedures on smokers, it is important that smokers be aware of the potential risks and side effects that smoking has on the surgery and post surgery healing. It may actually change their attitude towards smoking and its effects on the body.