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If You Continue To Smoke, We May Have a Problem: Smoking's Effects on Plastic Surgery

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Abstract

Smoking causes various aero-digestive neoplasms, some cardiovascular diseases, respiratory pathologies, and cardiovascular disorders. Surgeons have observed an association between impaired wound healing and smoking. In plastic surgery, cigarette smoking should be forbidden before and after surgery to prevent poor surgical results. In this retrospective study, we presented four major complications related with continuous smoking immediately after surgery. Although we have strongly forbidden smoking for every patient, 4 patients did not follow our advice and continued to smoke. One of them had a breast reconstruction with a pedicled transverse rectus abdominis musculocutaneous flap. Another patient had an abdominoplasty. The third and fourth patients had digital replantation and they were chronic smokers. After their poor surgical outcomes, these heavy smokers received close supervision, but managed to smoke, anyway. Education, psychologic consultation, and sometimes refusing to perform aesthetic or reconstructive surgery are required to minimize postoperative complications.

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References

  1. Arnez ZM, Bajec J, Bardsley AF, et al.: Experience with free TRAM flap breast reconstructions. Plast Reconstr Surg 87:470, 1991

    Article  CAS  PubMed  Google Scholar 

  2. Banic A, Boeckx W, Greulich M, et al.: Late results of breast reconstruction with free TRAM flaps: A prospective multicentric study. Plast Reconstr Surg 95:1195, 1995

    Article  CAS  PubMed  Google Scholar 

  3. Chang DW, Reece GP, Wang M, et al.: Effect of smoking on complications in patients undergoing free TRAM flap breast reconstruction. Plast Reconstr Surg 105:2374, 2000

    Article  CAS  PubMed  Google Scholar 

  4. Chang LD, Buncke G, Slezak S, Buncke H: Cigarette smoking, plastic surgery, and microsurgery. J Reconstr Microsurg 12:467, 1996

    Article  CAS  PubMed  Google Scholar 

  5. Coffman JC: Tobacco smoking and the peripheral circulation. Heart Bull 19:89, 1970

    Google Scholar 

  6. Craig S, Rees TD: The effects of smoking on experimental skin flaps in hamsters. Plast Reconstr Surg 75:842, 1985

    Article  CAS  PubMed  Google Scholar 

  7. Dintenfass L: Elevation of blood viscosity, aggregation of red cells, hematocrit values and fibrinogen levels in cigarette smokers. Med J Aust 1:617, 1975

    CAS  PubMed  Google Scholar 

  8. Forrest CR, Pang CY, Lindsay WK: Dose and time effects of nicotine treatment on the capillary blood flow and viability of random pattern skin flaps in the rat. Br J Plast Surg 40:295, 1987

    Article  CAS  PubMed  Google Scholar 

  9. Grazer FM, Goldwyn RM: Abdominoplasty assessed by survey, with emphasis on complications. Plast Reconstr Surg 59:513, 1977

    Article  CAS  PubMed  Google Scholar 

  10. Gu YD, Zhang GM, Zhang LY, et al.: Clinical and experimental studies of cigarette smoking in microvascular tissue transfers. Microsurgery 14:391, 1993

    Article  CAS  PubMed  Google Scholar 

  11. Hartrampf CR: The transverse abdominal island flap for breast reconstruction. Plast Reconstr Surg 79:703, 1988

    Google Scholar 

  12. Hartrampf CR, Bennet GK: Autogenous tissue reconstruction in the mastectomy patient. Ann Surg 205:508, 1987

    Article  PubMed  PubMed Central  Google Scholar 

  13. Krueger JK, Rohrich RJ: Clearing the smoke: The scientific rationale for tobacco abstention with plastic surgery. Plast Reconstr Surg 108:1063, 2001

    Article  CAS  PubMed  Google Scholar 

  14. Lovich SF, Arnold PG: The effect of smoking on muscle transposition. Plast Reconstr Surg 93:825, 1994

    Article  CAS  PubMed  Google Scholar 

  15. Moseley LH, Finseth F, Goody M: Nicotine and its effect on wound healing. Plast Reconstr Surg 61:570, 1978

    Article  Google Scholar 

  16. Mustoe T: In the discussion “Clearing the smoke: The scientific rationale for tobacco abstention with plastic surgery.” Plast Reconstr Surg 108:1074, 2001

    Article  Google Scholar 

  17. Nolan J, Jenkins RA, Kurihara K, et al.: The acute effects of cigarette smoke exposure on experimental skin flaps. Plast Reconstr Surg 75:544, 1985

    Article  CAS  PubMed  Google Scholar 

  18. Padubidri AN, Yetman R, Browne E, et al.: Complications of postmastectomy breast reconstruction in smokers, ex-smokers, and nonsmokers. Plast Reconstr Surg 107:342, 2001

    Article  CAS  PubMed  Google Scholar 

  19. Rao MS, Morrison WA, O'Brien BM: Effect of nicotine on blood flow and patency of experimental microvascular anastamosis. Ann Plast Surg 11:206, 1983

    Article  CAS  PubMed  Google Scholar 

  20. Rees TD, Leverett DM, Guy CL: The effect of cigarette smoking on skin flap survival in the face lift patient. Plast Reconstr Surg 73:911, 1984

    Article  CAS  PubMed  Google Scholar 

  21. Reus WF III, Colen LB, Straker DJ: Tobacco smoking and complications in elective microsurgery. Plast Reconstr Surg 89:490, 1992

    Article  PubMed  Google Scholar 

  22. Rudolph R, Hunt TK: Healing in compromised tissues. In: Rudolph R (Ed) Problems in aesthetic surgery. Mosby: St. Louis, p 65, 1986

    Google Scholar 

  23. Sarin CL, Austin JC, Nickel WO: Effects of smoking on digital blood flow velocity. JAMA 229:1327, 1974

    Article  CAS  PubMed  Google Scholar 

  24. Siana JE, Rex S, Gottrup F: The effect of cigarette smoking on wound healing. Scand J Plast Reconstr Surg Hand Surg 23:207, 1989

    CAS  PubMed  Google Scholar 

  25. Wagner DS, Michelow BYI, Hartrampf CR: Double-pedicled TRAM flap for unilateral breast reconstruction. Plast Reconstr Surg 88:987, 1991

    Article  CAS  PubMed  Google Scholar 

  26. Wilson GR, Jones BM: The damaging effect of smoking on digital revascularization. Two further case reports. Br J Plast Surg 37:613, 1984

    Article  CAS  PubMed  Google Scholar 

  27. van Adrichem LN, Hovius SER, van Strik R, van der Meulen JC: Acute effects of cigarette smoking on microcirculation of the thumb. Br J Plast Surg 45:9, 1992

    Article  PubMed  Google Scholar 

  28. van Adrichem LN, Hovius SER, van Strik R, van der Meulen JC: The acute effects of cigarette smoking on the microcirculation of a replanted digit. J Hand Surg (Am) 17:230, 1992

    Article  Google Scholar 

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Correspondence to Tayfun Aköz.

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Aköz, T., Akan, M. & Yıldırım, S. If You Continue To Smoke, We May Have a Problem: Smoking's Effects on Plastic Surgery. Aesth. Plast. Surg. 26, 477–482 (2002). https://doi.org/10.1007/s00266-002-2045-3

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