Latest Expert Witness News
Want a Face-Lift? First, Better Stop Smoking
Lisa Morrison has always considered herself a pillar of health. She ate only organic food, exercised often and meditated. The only glitch in her otherwise exemplary existence was the pack of Marlboros that she had inhaled daily since age 18.
By the time Ms. Morrison, now 50, went to see Dr. Vincent Giampapa, a board-certified plastic surgeon in Montclair, N.J., she had tried everything to quit for the sake of her health. “Acupuncture, the patch, hypnosis,” she said. “Nothing worked.”
Nothing, that is, until 2007, when Dr. Giampapa told her she would have to toss her beloved cigarettes if she wanted a neck- and eye-lift. “The doctor strongly suggested that if I wanted to heal properly I needed to quit,” Ms. Morrison said. “When you start talking about your face, it becomes motivating.”
Each year, roughly 40 to 45 percent of the 45 million smokers nationwide try to quit, according to Dr. Michael Fiore, the director of the University of Wisconsin Center for Tobacco Research and Intervention, in Madison. Only about 5 percent quit for life.
But these days, the growing number of cosmetic-surgery patients are motivated to quit for other reasons: vanity, and the threat of not being able to get a coveted new face, stomach or pair of breasts.
“When someone hears this from an internist or cardiologist who says it’s really bad for you, it increases your risk of lung cancer, it’s bad for your heart, people tend to blow that off if they’re feeling well,” said Dr. Alan Gold, the president of the American Society for Aesthetic Plastic Surgery. “But if they have a medical problem and are not going for just a routine checkup, they may tend to listen to that advice more.
“With plastic surgery it’s a little bit different. People are desirous of an elective procedure, and that’s their main objective in coming in. It’s something they truly want.”
For the last 5 to 10 years, many plastic and cosmetic surgeons have refused to operate on smokers, especially those seeking a face-lift, tummy tuck, or breast-lift — procedures that require skin to be shifted.
“Nicotine causes the tiny blood vessels in the skin to clamp down or constrict, which reduces blood supply to the skin,” said Dr. Darshan Shah, a plastic surgeon in Bakersfield, Calif. Complications can include poor wound healing, increased risk of infection, longer-lasting bruises, and raised, red scars.
“Twenty-five years ago, it may have been more acceptable for a patient to have undergone surgical procedures while smoking,” said Dr. Patrick McMenamin, the president-elect of the American Association of Cosmetic Surgery. “Nowadays if a doctor knew a patient was smoking and they did flap surgery,” he said, referring to an operation where shifting skin is required, “many of us would say that’s malpractice.”
Plastic and cosmetic surgeons recommend quitting a minimum of two weeks before and after procedures, though some require longer to be extra safe. (Smokers also run the risk of infection and respiratory complications during anesthesia). For instance, Dr. Jeffrey
back