When undergoing plastic surgery, tell your surgeon about your smoking habit

December 15, 2011

When blood supply is inadequate, which occurs with smoking, the tiniest veins often fail.
When blood supply is inadequate, which occurs with smoking, the tiniest veins often fail.

Smoking and plastic surgery are like oil and water, especially if you undergo breast lift, tummy tuck or facelift. Most shocking news is that a smoker who undergoes a breast lift may lose her nipples.

According to a Detroit plastic surgeon, as told to CNN on December 5, 2011, “The nicotine in cigarettes and the carbon monoxide contained in cigarette smoke can diminish blood flow to various parts of the body. These toxins act as a virtual tourniquet. If the blood flow to a particular body part becomes greatly reduced or halted, the body part dies.”

He is speaking from experience. While undergoing a breast lift, he saw a smoker’s nipples turn purple. He understood that purple is the precursor to black and black is the precursor to “falling off.” Think frostbite.

To save the patient’s nipples, the surgical team resorted to a medieval practice. They used leeches to suck out the excess venous blood from the body part, which acted as an attachable vein. The CNN article does not indicate where the leeches came from. If they are standard equipment in an OR, this is not a well known fact. The leeches drained the old blood, turning it from unhealthy purple back to healthy pink. The team persisted with the process, which took several days, until the body part grew new blood vessels to do the leeches’ work.

Now, in addition to a Surgeon General’s warning on cigarette packs, this plastic surgeon offers his own warning, which is not limited to breast lifts but extends to tummy tucks and facelifts. Smokers who undergo tummy tucks may get an infection resulting in a large open wound that takes three months to heal. If you’re a smoker undergoing a facelift, the skin on your cheek may turn black and slough off, leaving exposed fat.

When undergoing any plastic surgery procedure, make sure your surgeon is board-certified in plastic surgery by the American Board of Medical Specialties. When asked about your smoking habits or any health conditions you have or medications you are taking, do not be shy. Full disclosure will lead to the very best results. 


The mission of the American Society for Aesthetic Plastic Surgery (ASAPS) includes medical education, public education and patient advocacy. Plastic Surgery News Briefs are summaries of current stories found through various news and magazine outlets that relate to or mention plastic surgery and cosmetic procedures. The views expressed in these news articles do not necessarily reflect the opinions of ASAPS, but are merely published as an educational service to our members and the general public. For additional information on these subjects and other plastic surgery related topics, please go to www.surgery.org

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About ASAPS
The American Society for Aesthetic Plastic Surgery (ASAPS), is recognized as the world’s leading organization devoted entirely to aesthetic plastic surgery and cosmetic medicine of the face and body.  ASAPS is comprised of over 2,600 Plastic Surgeons; active members are certified by the American Board of Plastic Surgery (USA) or by the Royal College of Physicians and Surgeons of Canada and have extensive training in the complete spectrum of surgical and non-surgical aesthetic procedures. International active members are certified by equivalent boards of their respective countries. All members worldwide adhere to a strict Code of Ethics and must meet stringent membership requirements.

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