Smoking and vaping are associated with postoperative complications from both the anaesthetic and the surgical procedure.
Increased anaesthetic complications include respiratory problems due to a smoker’s inability to clear bronchial secretions, and also other general complications due other smoking-associated health problems such as heart disease.
Surgical complications usually appear around about 2-3 weeks after surgery when wounds start to breakdown and dehisce (that is, sutures start to give way). There is also an increased risk of wound infections and fat necrosis. Both of which can result in delayed healing (3+ months instead of the usual 3 weeks), readmission to hospital for intensive wound care, prolonged recovery, and poor scarring. Some smoking-related postoperative problems can also be associated with specific procedures, such as the increased risk of nipple necrosis (loss of nipple as they become gangrenous) in breast surgery, or the increased risk of facial skin necrosis (developing patches of gangrenous skin on the face) in facelift surgery.
It is now considered below standard of care and poor professional conduct for plastic surgeons to perform non-urgent elective surgery and/or cosmetic surgery on smokers, as this puts patients at unnecessary risk. This is particularly important for non-emergent surgery because in smokers, the risk of serious postoperative complications outweighs the benefits of surgery. That is, operating on smokers could make them worse than what they started with before surgery.
It is recommended that smoking should completely stop at least 8 weeks prior to surgery and abstinence should be continued for at least until your wounds have completely healed. The best outcome is achieved in those who have stopped smoking for 3 months or more.
Our Smoking Policy for Non-urgent Elective and Cosmetic Surgery
It is our practice policy that all patients undergoing non-urgent elective and/or cosmetic surgery MUST stop smoking at least 8 weeks prior to surgery. These patients must inform the surgeon and cancel their operation if they have smoked during that time. All ex-smokers who have only ceased smoking within 6 months of surgery will have both a urine and saliva test on the day of admission. If either test is positive, the surgery will be cancelled.
If the patient smokes within 8 weeks of surgery and informs us to cancel the surgery at least 10 days prior to surgery, the booking fee will be refundable, and no surgical fees will be charged. However, if cancellation occurs on the day due to non-attendance or due to positive tests, both the booking fee and 10% of the surgical will NOT be refundable.
Focus on Patient Safety
Our policy is in place to protect our patient’s best interests and to provide them with the best possible outcome. The focus of our practice is to always ensure that we only deliver the best standard of care available and adhere to recommended protocols based on the best clinical evidence. Our priority is patient safety.