surgery for smokers
your surgeon says NO
board-certified plastic surgeons limit the cosmetic surgery procedures they perform on smokers because smoking increases the risk of pulmonary complications and can impede wound healing, which may decrease the quality of surgical results.
What to do if you smoke but would like to have
||Everyone must have seen Dr. Robert Rey, the flamboyant plastic surgeon who starred in the reality show Dr. 90210 on the E! Entertainment Channel. This was a highly popular reality show based on the life of
Beverly Hills plastic surgeons. Dr. Rey is a son of Hispanic immigrants and that is why he does a lot of charity work in the Hispanic community. He also speaks Spanish. In one case, he decided to perform plastic surgery on this extremely poor
Latina who was also
addicted to smoking. Prior to surgery, he warned her not to smoke. However, she was addicted to a point that she could not resist. At the time of the surgery, it took no time for the doctor to find out that she did not follow his instructions. The surgery went OK and she recovered, but it did not make Dr. Rey happy.
In another episode, Dr. Rey actually refused to
cancelled the surgery for an actress who did not
disclose her smoking habit on time. While she was
absolutely mad and blamed him for a loss of $20,000 in
potential income for three weeks, Dr. Rey said that he
wanted to do the right thing. (Related article: Plastic
surgery for Hispanic men and women)
Like him, most plastic surgeons do not want to deal with smokers because when the results don't come out good, the patients blame the surgeon. While surgeons are willing to work with a patient, the majority of the surgeons polled said they would cancel a patient's scheduled surgery if he/she did not follow their guidelines.
Similarly, surgeons also recommend that
patients disclose their use of herbal supplements at the
time of consultation.
||Rod J. Rohrich, MD, and colleagues at the University of Texas Southwestern Medical Center report survey results from 955 board-certified plastic surgeons about their practice standards regarding treatment of patients who smoke that ninety percent of them said they perform only elective plastic surgery on smokers. Approximately 50 percent of this group limit the type of procedure they perform on smokers. "Tobacco smoke contains more than 3,800 identified substances, of which nicotine and carbon monoxide are two of the most detrimental to wound healing and may cause pulmonary complications," said Dr. Rohrich. "This impaired wound healing may dramatically decrease the final cosmetic outcome."
Eighty-eight percent of plastic surgeons surveyed said they would perform procedures that did not involve skin flaps or skin separation, such as nose reshaping, or
liposuction. However, only 39 to 54 percent of plastic surgeons would perform procedures involving more skin manipulation, such as reduction,
tucks, or face
Sixty percent of surgeons surveyed said they "usually" or "always" perform a less invasive technique on smokers. While a third of respondents said they "sometimes" change their technique.
To help smokers reduce the risk of complications, some plastic surgeons require patients to
quit smoking prior to
surgery. Just over 40 percent of those polled require patients to quit for a time period of two weeks. To help patients "kick the habit," some plastic surgeons offer patients smoking cessation aids, such as oral medication or
additional reasons for women to stop smoking since their children
might be deformed and will need plastic surgery later on. In the largest study of its kind, plastic surgeons found smoking during pregnancy significantly elevates the risk of having a child with excess, webbed or missing fingers and toes, according to the Plastic and Reconstructive Surgery Journal.
"Reconstructive surgery to repair limb, toe and finger
abnormalities in children represents a large portion of my practice - it is the most common issue I treat," says Dr. Benjamin Chang. "Parents would ask why this happened to their child, but I didn't have an answer. This study shows that even minimal smoking during pregnancy can significantly increase the risk of having a child with various toe and finger defects."
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