In the recent Bulletin of the American College of Surgeons, there was a reference to a paper that was published in the medical journal Archives of Internal Medicine. The study, done in England, was an analysis of the effect of smoking cessation prior to surgery. It was noted that, “Worldwide, more than 70 million adult smokers undergo major surgical procedures every year.” That is a big number. And of course there are the issues of other medical conditions that some of these patients may have, which play into the risk factors.
In elective cosmetic surgery, typically patients are healthy and carry less risk. However, smoking up till the time of surgery is definitely a “no-no.” The study was comfortable in its conclusions that eight weeks without smoking prior to surgery significantly reduced the risk factor. Our experience has confirmed that.
However, it should be noted that cigarette smokers generally have poorer circulation as a result of many years of smoking. Therefore the surgeon still has to take into account the extent of the procedure and the risks therein when the patient has a history of smoking, since their skin circulation, even without smoking two months prior to surgery, may still be impaired.
- Robert Kotler, MD, FACS
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