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All procedures in plastic surgery are performed to improve form and, in some cases, function. Our goal as Plastic Surgeons is to have a perfect form and perfect scars. Unfortunately, smoking and secondary smoke affect wound healing in potentially a very devastating way. Any exposure to smoke either directly or indirectly can result in poor wound healing, delayed wound healing, skin loss necessitating skin grafting, increased risk in wound infection and loss of skin and deeper tissues, all resulting from decreased blood supply to those areas.

The diminished blood flow to skin wound edges can cause the breakdown of skin and scabbing. Also, there are well-known increased risks with anesthesia such as increased chance of developing pneumonia.

Again, remember that slow wound healing (months instead of weeks), skin loss resulting in scabbing and prolonged need for dressing changes, and infection usually involving the need for antibiotics (but sometimes another surgery to drain the infection) all are complications that can occur at a much higher risk if you smoke or are exposed to smoke (Instead of less than 5%, it can be as high as 60% ).

Smoking is also a proven creator of free radicals. Smoking has also been directly linked with elevations in matrix metalloproteinase-1, a zinc dependent protein responsible for the degradation of skin dermal collagen.

Please be honest with your surgeon so that they can take good care of you and help prevent problems. These are totally elective operations so there is no reason to take any unnecessary risks. If your surgeon tells you smoking is not a problem, I would think twice about your choice of surgeon.

To bring the point home, please look closely at the below pictures from an ASPS study on identical twins with different smoking histories. Notice the remarkable difference in skin quality and aging. Smoking is bad for your skin and makes you age faster.


Why should I quit smoking?

Smoking cigarettes tops the list of major risk factors of our number on killer- heart and blood vessel disease. In fact, almost one-fifth of deaths from heart disease are caused by smoking. The long list of diseases and deaths due to smoking is frightening. Smoking also harms thousands of nonsmokers who are exposed to cigarette smoke, including infants, kids and children.
If you smoke, you have good reason to worry about its effect on your health, your loved ones, and others. You could become one of the more than 430,000 deaths smoking causes every year. When you quit, you reduce that risk tremendously

No matter how much or how long you’ve smoked, when you quit smoking, your risk of heart disease and stroke starts to drop. In time, your risk will be about the same as if you’d never smoked.

List your reasons to quit and read them several times a day. Wrap your cigarette pack with paper and rubber bands. Each time you smoke, write down the time of day, how you feel, and how important that cigarette is to you on a scale of 1 to 5. Rewrap the pac

Step One

List your reasons to quit and read them several times a day. Wrap your cigarette pack with paper and rubber bands. Each time you smoke, write down the time of day, how you feel, and how important that cigarette is to you on a scale of 1 to 5. Rewrap the pack

Step Two

Keep reading your list of reasons and add to it if you can. Don’t carry matches, and keep your cigarettes out of easy reach. Each day, try to smoke fewer cigarettes, and try not to smoke the ones that aren’t most important

Step three

Continue with Step Two. Set a target date to quit. Don’t buy a new pack until you finish the one you’re smoking. Change brands twice during the week, each time for a brand lower in tar and nicotine. Try to stop for 48 hours at one time.

Step four

Quit smoking completely. Throw out all cigarettes and matches. Hide lighters and ashtrays. Stay busy! Go to the movies, exercise, take long walks, go bike riding. Avoid situations and “triggers” you relate with smoking. Find healthy substitutes for smoking. Carry sugarless gum or artificially sweetened mints. Munch carrots or celery sticks. Try doing crafts or other things with your hands. Do deep breathing exercises when you get the urge

It’s hard to stay a nonsmoker once you’ve had a cigarette, so do everything you can to avoid that “one.” The urge to smoke will pass. The first 2 to 5 minutes will be the toughest. If you do smoke after quitting: This doesn’t mean you’re a smoker again – do something now to get back on track. Don’t push or blame yourself – tell yourself you’re still a nonsmoker. Think about why you smoked and decide what to do the next time it comes up. Sign a contract to stay a nonsmoker

Your sense of smell and taste come back. Smoker’s cough goes away. You will digest more normally. You will feel alive and full of energy. You breathe much easier. It’s easier to climb stairs. You’re free from the mess, smell, and burns in clothing. You feel free of “needing” cigarettes. You’ll live longer and have less chance of heart disease, stroke, lung disease, and cancer.

Talk to your doctor, nurse, or health care professional or call your local American Heart Association at 1-800-242-8721, or the American Stroke Association at 1-888-478-7653.
If you have heart disease or have had a stroke, members of your family also may be at higher risk. It’s very important for them to make changes now to lower their risk



When I first published The 7 Critical Questions to Ask Before Letting Any Surgeon Touch You, I had no idea that it would be so popularly received. Since its publication, this brief guide has helped thousands like you to more safely navigate the world of cosmetic surgery. The 7 Questions have been updated and a bonus section, Applying the 7 Questions, has just been added. Be my guest to read, learn and share.