Smoking and Tummy Tuck-Is It Safe?*

This is a 45-year-old woman who had 2 children in the past and had loose skin of her lower abdomen and desired cosmetic improvements. She was a 1 pack per day smoker. She did also consider liposuction. Dr. Lyle counseled her to quit smoking for at least 4 weeks prior to surgery and recommended against performance of additional liposuction the patient underwent successful abdominoplasty. There were a few small areas of wound healing problems along the abdominal incision however they eventually healed without significant problems. It is well known that smoking interferes with wound healing and these problems are magnified during many cosmetic procedures where skin flaps are dissected. Whether it is a breast reduction, breast lift, tummy tuck or facelift, separation of the skin and subcutaneous tissue from the blood supply leads to poor blood flow and smoking causes microvascular disruption of blood flow to the skin. Additional liposuction can potentially further disrupt blood flow so in many instances additional liposuction can add to the risk. What is that risk? Skin healing problems which could lead to a dead tissue which can cause poor scarring and potentially open wounds. Patients are counseled to cease smoking at least 4-6 weeks prior to surgery and may not resume smoking postoperatively. Even with smoking cessation, blood flow never returns to normal so more conservative procedures are recommended to ensure proper wound healing.