Perioperative smoking results in significantly higher complication rates (specifically, wound healing complications) that are unrelated to the number of cigarettes smoked.

Our experience has shown that we cannot turn a smoker into a nonsmoker. Our experience, however, suggest that extreme discretion should be exercised when offering plastic surgery procedures to smokers.

Smokers must know about their possible higher risk for wound healing problems.

As we perform the operation we try to be more conservative, mobilize less, remove less tissue, and immobilize the patient in the critical first 3 days to prevent them from smoking. With reference to our anecdotal evidence, we have since noticed a significant reduction in the incidence of wound healing problems.