Tobacco.org

• Skin Deep - Want a Face-Lift? First, Better Stop Smoking  

the growing number of cosmetic-surgery patients are motivated to quit for other reasons: vanity, and the threat of not being able to get a coveted new face, stomach or pair of breasts. . . .

For the last 5 to 10 years, many plastic and cosmetic surgeons have refused to operate on smokers, especially those seeking a face-lift, tummy tuck, or breast-lift — procedures that require skin to be shifted.

“Nicotine causes the tiny blood vessels in the skin to clamp down or constrict, which reduces blood supply to the skin,” said Dr. Darshan Shah, a plastic surgeon in Bakersfield, Calif. Complications can include poor wound healing, increased risk of infection, longer-lasting bruises, and raised, red scars. . . .

Plastic and cosmetic surgeons recommend quitting a minimum of two weeks before and after procedures, though some require longer to be extra safe. (Smokers also run the risk of infection and respiratory complications during anesthesia). For instance, Dr. Jeffrey Rosenthal, the chief of plastic surgery at Bridgeport Hospital in Connecticut, mandates six weeks of smoke-free living before eyelid surgery or breast augmentation, and six months to a year before a tummy tuck.

They also take it upon themselves to devise smoking cessation plans, prescribe drugs like Wellbutrin or Chantix and recommend hypnotists or support groups. . . .

Then there’s the matter of the cosmetic surgeon’s reputation. It can’t help business if a cigarette-loving patient ends up looking like the Bride of Frankenstein.

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Twenty-five years ago, it may have been more acceptable for a patient to have undergone surgical procedures while smoking. Nowadays if a doctor knew a patient was smoking and they did flap surgery [an operation where shifting skin is required] many of us would say that’s malpractice.
Dr. Patrick McMenamin, the president-elect of the American Association of Cosmetic Surgery.