Patients may wonder why it is important to stop smoking before, during and after surgery? This is simply because of nicotine and not the cigarette itself (please see article https://bit.ly/2C5gTE3).
Patients who use it and have elected for surgery must be aware of the main associated risks and complications:
· The impact of nicotine on decreasing blood circulation has a significant impact on the body’s ability to heal itself as it cuts off the blood supply and impairs healing.
· This means you are 3 times as likely to have infections, wound break down and haematomas.
· Wound breakdown can be complete necrosis of the skin which will potentially take months to heal and may involve multiple surgeries to correct.
· This is most important for surgeries where large areas of skin are undermined as the skin already has reduced perfusion because of surgery. Under these circumstances, nicotine can tip the balance into having a complication. This includes, abdominoplasty, breast reduction, mastopexy and facelifts. However, it will affect any surgery.
· You need to stop nicotine products for two weeks before surgery for these risks to go back to normal.
· The hospital often checks whether you are smoking by using a urine or breath test at your pre-op assessment. If you are found to be smoking, then we may need to cancel your surgery and you could potentially be liable for a cancellation fee.
· Some patients tell me they wish they had not mentioned they were smoking. I understand it is very disappointing if you are cancelled but it would be far worse to have a serious complication from surgery. Unless surgery is urgent then it can be delayed until a later date rather than risk an unsatisfactory result.
· Often patients who do not smoke but use other nicotine-based products – such as e-cigarettes, vapes, patches or gum – wonder if these risks apply to them. The answer is yes because all contain nicotine.
In simple terms, all patients who use nicotine must cease at least two weeks prior to and after surgery. Always guided by safety, I will not operate on any patient that continues to smoke or use nicotine within this timeframe. A patient’s local General Practitioner is the best person to seek for advice on how to quit smoking or for more information go to this helpful NHS link.