At Carolina Facial Plastics, nothing is more important than your health. The risks of smoking are well known, and are increased risk of stroke, heart attack, cancer, and lung disease, but smoking will also dramatically increases your chances of a complication after a facial plastic surgery procedure. The nicotine in the tobacco attacks the small blood vessels in your body resulting in poor circulation.
Smoking effects the heart, lungs, and blood vessels, and also complicates the anesthesia during a facial cosmetic surgery procedure. It may be harder for the anesthesiologist to control your blood pressure or may effect the medications they use. Anesthesia is done safely everyday on people who smoke for non-elective procedures, but for elective cosmetic surgery, at our surgery centers in Charlotte and Columbia, we do not believe in taking any undo risks.
During a facelift, or rhytidectomy, the skin is lifted and redraped to create a tighter, smoother, and refreshed face. The major blood supply in the skin is the small blood vessels that are attacked by nicotine. If the skin does not receive enough nutrients through the blood, the skin may die. This then requires intensive care and results in a less than ideal outcome. In my opinion, for any surgical procedure this is not acceptable. Studies show that smoking increases the chances of the skin dying by over 20 times!
An open rhinoplasty, or nose job, requires lifting of the skin of the nose to be able to manipulate the underlying bone and cartilage to shape the nose. The skin of the nose is also supported by the small blood vessels that are affected by nicotine. Again, smoking places an unacceptable increased risk on the nasal skin for poor healing. This risk is even greater in a person undergoing a revision rhinoplasy, or a repeat nose job.
As a board certified head and neck surgeon and a fellowship trained cosmetic surgeon, I believe in safety first, and am extremely cautious in treating patients that smoke tobacco. The literature states that patients undergoing elective cosmetic procedures should stop smoking for at least 4-8 weeks before surgery. It is well known that your body has the ability to continue to heal itself ever after 8 weeks. If you have even a 1% chance of improved outcome for waiting longer, then why not wait? I always think, what would my recommendation be to my mother or any other family member? You have to take every patient’s situation differently. If a patient smokes less than one pack of cigarettes a month, I would recommend waiting eight weeks for any surgery. For a heavier smoker, I will not preform surgery for 4-6 months, and for very heavy smokers I will sometimes wait for one year. In all of my patients with a history of smoking, I will get a lab test before the surgery to ensure that there is no nicotine in the blood system.
Marijuana can effect the outcome of a facial plastic surgery. Marijuana can effect the healing and the effectiveness of the anesthesia during a facelift, rhinoplasty, or any other facial plastic procedure. It is important to tell your physician if you do smoke marijuana or have taken any other substances, legal or illegal. You cannot get in trouble or be arrested for telling your physician this information. Please tell your doctors about these substances so they can keep you safe!
Dr. Jonathan Kulbersh is a facial plastic surgeon. He has offices in Charlotte, North Carolina and Columbia, South Carolina. He would welcome the opportunity to meet and discuss any facial aesthetic questions in his practice serving Southpark, Meyers Park, Eastover, Dillworth, Ballentyne, Huntersville, Mooresville, Lexingtion, Irmo, Rock Hill, or Lake Norman areas.