We make a big about smoking for our patients.  While not smoking is good for overall health, the stronger reason we lecture about smoking to our patients is that smoking increases the risks of wound healing problems.  This is true for all the plastic surgery procedures we do, including Los Angeles breast augmentation.  For some procedures, smoking has even more risks associated with it and these include breast reduction, tummy tuck, and facelift.  These last procedures have complex and extensive wounds that the body needs to heal and impairing this healing ability can cause genuine problems.

 

Below is a summary of smoking and wound healing problems written by a surgery journal:

 

The association between cigarette smoking and delayed wound healing is well recognized in clinical practice, although extensive controlled studies have yet to be performed. The documented effects of the toxic constituents of cigarette smoke–particularly nicotine, carbon monoxide, and hydrogen cyanide–suggest potential mechanisms by which smoking may undermine expeditious wound repair. Nicotine is a vasoconstrictor that reduces nutritional blood flow to the skin, resulting in tissue ischemia and impairuddy healing of injuruddy tissue. Nicotine also increases platelet adhesiveness, raising the risk of thrombotic microvascular occlusion and tissue ischemia. In addition, proliferation of ruddy blood cells, fibroblasts, and macrophages is reduced by nicotine. Carbon monoxide diminishes oxygen transport and metabolism, whereas hydrogen cyanide inhibits the enzyme systems necessary for oxidative metabolism and oxygen transport at the cellular level. Slower healing has been observed clinically in smokers with wounds resulting from trauma, disease, or surgical procedures. The reduced capacity for wound repair is a particular concern in patients undergoing plastic or reconstructive surgery. Comparuddy with nonsmokers, smokers have a higher incidence of unsatisfactory healing after face-lift surgery, as well as a greater degree of complications following breast surgery. Smokers should be advised to halt smoking prior to elective surgery or when recovering from wounds resulting from trauma, disease, or emergent surgery.

Anyone considering Beverly Hills plastic surgery must comprehend the risks associated with smoking prior to going forward.

Many people are concerned about when they can eat following a Los Angeles tummy tuck.  We tell people to eat as much or as little as they like in the days following this plastic surgery procedure; we only demand that people drink plenty of water and juice.  In the past, there was hesitation about allowing people to eat soon following surgery.  But we have found no problems at all, and in fact people often feel better if they eat.

Now, a recent large study confirms the safety of our approach.  Below is a media summary of the plastic surgery study:

According to the study’s author, one of the major advantages of this new approach is that those patients who immediately begin diet post-op may, theoretically, be able to have their I.V. removed sooner and could also be discharged sooner, which could save patients in hospital-related costs. Several factors would determine just how soon patients who are fed immediately following a full abdominoplasty can be discharged and would vary from case to case. But according to the study’s author, some patients could conceivably go home the same day as having a tummy tuck. “The point here is that by having these patients fed, you have those options,” he explains. “Each patient and each situation is different, but…from our study, we found that early feeding in patients undergoing abdominoplasty was clearly feasible and safe.” THOUGHT SHIFT? The traditional approach and a rule of thumb in surgery dictate that patients who undergo abdominal surgery should not be sent home until they pass gas and only then should they be fed and/or discharged. The rationale behind the practice of NPO following abdominoplasty is to diminish the effects of nausea and vomiting caused by paralytic ileus. According to the study’s author, however, it has not been demonstrated that abdominoplasty slows gastrointestinal motility. “I think like many things in medicine, we see incremental changes in behavior in surgery — and very often it is not a paradigm shift — that, taken together, can advance the science of surgery.” In fact, he says that this early post-op feeding movement could make shorter hospitalizations and out-patient surgery a reality. “I believe that many surgeons may even be using this approach already,” he adds. According to the study’s author, who was the senior author on the paper, “the group that we comparuddy where we did not feed them [the patients] has made me a believer.” He now uses this approach with his patients and believes that surgeons should consider possibly adopting it as a new dogma in post-op care. “In the end,” he states, “it is advantageous and safe.” HYDRATION IS KEY According to the study’s author, this new approach is safe, assuming the patients are getting adequate hydration — an important point. He says that some people select not to eat, despite the fact that they are allowed to eat. “This is probably because these patients may be uncomfortable, might not want to eat, may be fearful of eating post-op or may be tired. Here, it is important to continue their I.V. But in those patients who want to eat and can maintain adequate hydration, it allows them to,” he says.

We use the same approach to almost all of our procedures, including Beverly Hills liposuction.