Quick blog. When doing my recent CME there was a question about smokers and tummy tucks. A tummy tuck involves elevating a skin flap. This is particularly dicey for patients who smoke, as we know smoking affects blood supply via multiple channels, from lowering the caliber of vessels, to vasospasm, to hurting the small microcirculation of the blood supply.
This is information was in one of the answers on the continuing medical education test. It was striking enough that I screenshotted it to remind me to write a blog.
Facts you should know:
- In a series of 132 patients (Manassa, 2003), looking at smoking and its relationship to wound healing problems after abdominoplasty, they found smokers had a 49.7% risk of healing issues (versus 14.8% in nonsmokers)
- This study was followed up by studies in 2007 and 2008, which showed a significant link between smoking and risk of infection and wound helaing issues.
- Of note here, they saw the risk was not just related to a history of smoking, but THE RISK WAS PROPORTIONAL TO THE NUMBER OF CIGARETTES SMOKED OVER A LIFETIME.
My thoughts?
I didn’t know the risk was proportional to the number of cigarettes smoked over a lifetime. This indicates a heavy smoker who quit 20 years ago is a higher risk still than a lighter smoker who quit two months ago. I also think the study showing the healing issue risk of 50% in smokers is quite stark.
So don’t smoke, particularly if you want a tummy tuck, breast lift, breast reduction, or facelift anytime in the future. These are all flap surgeries, and heavily dependent on blood supply.
And please know in this era of vaping and pot, smoking is smoking. I am sure there may be some nuances in the risk between smoking tobacco, smoking pot, or vaping either, but all of these have been shown to affect healing.
