Why do I need to give up smoking before a rhinoplasty procedure?

One thing that is always discussed during your cosmetic surgery consultation with Milton Keynes based plastic surgeon Mr Sudip Ghosh, regardless of the nature of the operation, is whether you smoke and, if the answer is yes, then Mr Ghosh will give you advice on how far in advance of surgery you should stop smoking and for how long afterwards.

Cosmetic surgery aims to enhance the face or body. This involves making incisions into the skin and moulding, shaping or removing tissue. Certain procedures, such as the ever-popular breast augmentation, entail the insertion of a foreign body in the form of an implant. All this requires our bodies to heal themselves afterwards and smoking can have a devastating impact on our ability to heal.

How does smoking damage the healing process?

Simply put, for tissues to heal they need a good supply of oxygenated blood and smoking lowers levels of oxygen in the blood. Tissues that do not get enough oxygenated blood – a condition known as ischemia – can potentially ‘die off’ or, at the very least, take much longer to heal.

Smoking causes levels of oxygen to drop in the blood because carbon monoxide binds itself to your red blood cells far more effectively than oxygen can and, at the same time, nicotine is constricting the size of your blood vessels. Nicotine can also make blood more likely to clot, clogging up the smaller blood vessels and capillaries in the skin.

It is true that for certain procedures it is even more important to quit smoking and that includes rhinoplasty. It depends how vascular the area that is being operated on and what is taking place during the procedure.

Other problems associated with smoking

At this year’s Euroanaesthesia meeting, held in Berlin, research was presented that proved that smokers (and even passive smokers) required more anaesthetic and painkillers than those that didn’t smoke. A study that compared a group of smokers, a group of passive smokers and a group of non-smokers, found that smokers needed 33 per cent more anaesthetic and 23 per cent more pain relief after the procedure to gain the same effect as for non-smokers. Interestingly, passive smokers required 20 per cent more anaesthetic and 18 per cent more pain relief.

It’s thought that nicotine affects how anaesthetic drugs metabolise in the liver. Another theory is that it desensitises who our nerve cells respond to pain.

Smoking also makes you far more susceptible to infection; a recent survey found that smokers are 30 per cent more likely to develop infections after surgery.

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