A ^Retired Plastic Surgeon's Notebook

Smoking and tummy tucks – a bad combination that makes me wanna holler.

There’s nothing that makes me wanna holler much more than an anatomically perfect patient for tummy tuck who smokes!

Last week I saw two patients in one day who were both absolutely anatomically perfect patients for tummy tucks.  They were both done with child bearing, they were both thin and both had abdominal muscle separation and loose jelly belly skin and they both had c-section scars.  This kind of patient makes me almost droll at the thought of how straight forward their surgery would be, how much improvement they would have and, most of all, how happy theywould be with their surgical result.

That was the ectacsy part of the consultation and now for the agony part.  Both of these patients were long time and dedicated smokers.  And that made them very, very poor candidates for tummy tuck regardless of their favorable anatomy.

The issue with smoking is the damage that smoking does to blood vessels.  With many procedures such as tummy tuck, face lift, breast lift and some body lifts, the blood supply of the skin is stressed because the skin must be peeled up for a distance either to remove extra skin or to alter structures under the skin.  Peeling the skin up cuts many, many small vessels that provide circulation to the peeled up area and that area is then dependent on a secondary blood supply for post-operative healing.   In a smoker, that secondary blood supply is not reliable and the chance for the peeled up skin dying is much higher than a non smoker.  We surgeons have a fancy name for things that die – necrosis and it’s a word I loath using in describing a post surgical wound in my post-operative notes.

So I had to deliver the two smokers that bad news that I could not operate on them until they were non smokers for at least three months and even then, they are still at increased risk for healing problems.   I am sure I am not the first doctor to tell them they should quit smoking but maybe, just maybe, if they want than tummy tuck enough, they will finally find the strength to kick the habit.

 

Category: Body Contouring, General Health, Mommy Makeover, Patient Safety, Plastic Surgery, Tummy Tuck, Uncategorized | Tags: , , ,

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