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Why would a facial plastic surgeon care if you smoke?
“Yeah, yeah,” you think, “of course, everyone knows smoking is bad for your lungs, but smoking doesn’t affect my face, and it makes me look cool, right?”
Smoking, unfortunately, does nothing good for the way you look. In addition to all the bad things you have likely heard about smoking hurting your health, it is can also be devastating to your appearance. The nicotine in cigarettes causes constriction of the tiny blood vessels that feed the skin and soft tissue of the face. This leads to premature aging, more wrinkles and tissue sagging. It also dehydrates the skin and will lead to a rougher, more crinkly appearance.
You may think, “Oh, well, I’m just going to keep smoking, and when I look old, I’ll just have a facelift fix it.”
Unfortunately, research studies have shown that smokers have a greater than tenfold rate of complications from these and other surgeries to rejuvenate the appearance of the face. Often plastic surgeons will even refuse to offer elective operations to smokers to prevent such complications.
Your surgeon understands that smoking is very tough to quit, and no one plans on acute events, such as car wrecks or other traumas. No one plans on developing a cancer on their face, or elsewhere in the head and neck. The stress from such events in your life can make it that much tougher to quit smoking.
Of course, your surgeon will work with you to do everything in his/her power to restore your form and function to as close to the way things were before. But it definitely limits the options he or she has to offer you in the form of certain reconstructive techniques such as flaps and grafts, as these can be compromised by smoking.
Can you still get Botox if you smoke? Yes, nicotine is not a contraindication for treatment of wrinkles with Botox. Unfortunately, smokers are more likely to need it much sooner than if they didn’t smoke. Studies in identical twins have shown statistically significant differences in the age of appearance between twins when one was a smoker and the other did not smoke.
Smoking increases the chance you may develop cancer of the skin of the face, the voice box, throat and tongue. Unlike cancer of the breast, colon or prostate, these head and neck cancers are almost impossible to hide from others. It can affect every person-to-person interaction you have for the rest of your life.
Sometimes it might require tissue to be borrowed from other parts of your body to reconstruct the defect left behind after the cancer is removed. Sometimes it might be necessary to have a plastic tube inserted into the neck to help you breathe. And sometimes your ability to speak and swallow are permanently damaged, leading to feeding tubes and the interruption of speech requiring use of sign or written language for communication.
Well, you may think: “Sure, I know smoking will shorten my life, but I’d rather enjoy the time I am living.”
I would argue the points above could significantly impact the ability of the smoker to enjoy everyday life. No matter how self confident one is, I don’t know a single person who doesn’t look in the mirror when they get ready in the morning. Is the pleasure of smoking worth wrecking that?
Dr. Scott Asher is a fellowship-trained facial plastic surgeon, the director of The Facial Plastic and Reconstructive Center and a member of the Tallahassee Memorial HealthCare medical staff.
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