The study led by Dr Aaron Van Slyke, from the University of British Columbia in Vancouver – which is also published on Plastic and Reconstructive Surgery journal – discovered that surgeons who call for pre-operative smoking cessation may influence patients' long-term smoking status.
"Our results show an association between cosmetic surgery and smoking cessation at long-term follow-up," according to Dr Van Slyke.
The follow-up study’s result further revealed that out of the 85 smoking patients evaluated, approximately 40% of patients said they no longer smoked cigarettes on a daily basis. Nearly one-fourth had not smoked at all since their cosmetic surgery procedure.
In order to accumulate more substantial results, Dr Van Slyke and his team refrained participating patients from smoking two weeks before they undergo their respective cosmetic surgery – following the standard procedure required to be taken by all doctors.
Following up the study, only 47 patients responded to the follow up survey that was done five years after their respective surgery. Most of the patients were women, with an average age of 40 years. The most common procedures were tummy tuck (abdominoplasty), breast lift (mastopexy), and facelift.
Nonetheless, five patients were excluded due to their lack of cigarette consumption – all being social smokers, who do not smoke on a daily basis, and the remaining 42 patients were evaluated.
The result also found that half of the patients admitting to defy doctors’ orders by smoking up until the day of the surgery. Ultimately, the study gathered that the complication rate after cosmetic surgery was higher in patients who carried on smoking: 24% versus 14% with two patients evidently facing major complication during the healing process (due to neglecting doctor’s order pre-op).
Due to the negative effects of smoking on wound healing, many plastic surgeons are unwilling to perform cosmetic surgery procedures in patients who continue to smoke.
To quit or not to quit: The underlying consideration factorWhen asked what prompted patients to quit or reduce their smoking habit, 17 of 24 patients agreed that discussing the adverse effects of smoking on their ‘surgical outcome’ influenced their ability to quit or reduce their cigarette consumption. On the contrary, 10 out of 24 patients were influenced by a discussion about the adverse effects of smoking on their ‘overall health’.
In an older study, Lennard Chan suggested that surgeons who perform urine cotinine test are more likely to receive compliance patient in terms of quitting the ciggy habit. The study in 2006 found that 80% of 65 patients who underwent reduction mammaplasty admitted to not complying with the recommended 4-week preoperative smoking cessation period, as the surgeon did not perform urine cotinine confirmatory testing. On the other hand, other studies that used urine cotinine confirmatory testing report a lower rate of non-compliance preoperatively. Dr Van Slyke added that patients who are aware that they will receive urine confirmatory testing are more willing to comply with preoperative smoking cessation recommendations.
On the rise: Cosmetic surgeries around the globeAccording to the global statistics reported by International Society of Aesthetic Plastic Surgery (ISAPS), there was an overall increase of 9% in surgical and non-surgical cosmetic procedures, completed in 2016. The top five spots saw the United States snagging the first place, with a total of 4,217,862 number of procedures; followed by Brazil (2,524,115), Japan (1,137,976), Italy (957,814) and Mexico (923,243), respectively.
The fastest growing procedures reported to be labiaplasty, with a 45% rise since 2015; followed by lower body lift which increased by 29%. Breast augmentation using fat transfer indicated a 22% growth in the number of procedures, while buttock lift increased by 20%.
Back in Malaysia, the demand for vaginaplasty tops the chart of plastic surgery treatments. With the number of aesthetic clinics in the country booming rapidly in the past 10 years, most Malaysians undergo minor cosmetic procedures such as injection of botulinum toxin (or Botox), fillers and platelet-rich plasma (PRP) to reduce wrinkles, and laser treatments to lighten dark spots. More recently in July, a Malaysian man has spent up to RM200,000 on cosmetic procedures to look like Squall, a character from Final Fantasy 8.
Ultimately, there may be an opportunity for the plastic surgeon to promote healthy lifestyle modifications that may extend beyond the perioperative period, when recommending smoking cessation before cosmetic surgery to patients. The study also concluded that "the dialogue between plastic surgeon and patient during the cosmetic surgery consultation serves as a unique moment to provide targeted smoking cessation counselling that may persist well beyond the surgical interaction." MIMS
The international study of aesthetic/cosmetic procedures performed in 2016. Source: ISAPS
Buzzing on social media: Plastic surgery ads can be misleading to consumers
Patients should be prepped before surgery, new study suggests
Open access to vape products in Malaysia can reduce smoking rates, says think tank