Hallo, welcome to our frequently asked questions.
Today I'm answering a frequently, asked question about smoking
and whether I can have lower blepharoplasty if I'm a smoker.
And in answering this question we'll talk about
what are the effects of smoking
on the lower eyelid, lower blepharoplasty.
We'll talk about stopping smoking and other parts of that
or whether you can use nicotine patches
and whether you can use vaping.
And finally we'll talk about,
well, advice that I give to my patients that,
in terms of reducing the risks and enhancing your healing
if you're smoker and undergoing lower blepharoplasty.
So, my name is Dr. Julian De Silva
and I'm a London based Facial Cosmetic and Plastic surgeon.
And Blepharoplasty is one of the commonest procedures
that I complete for patients on a daily basis.
And the information that I'm discussing with you today
is information that I share with my patients,
on a regular basis.
So, in terms of lower blepharoplasty,
well, how does smoking affect healing?
Well, smoking affects the way that oxygen and nutrients
are carried in the body.
And this is particularly relevant for the lower eyelid
in terms of healing.
And if there is an impairment due to smoking
in the way oxygen is carried to the lower eyelid,
then this can affect healing.
And ultimately if there is a, an effect on healing
this can result in delayed healing.
This can result in, in infection
and this can also result in scarring
and a combination of all of these.
In addition to that, to those effects,
well, smoking also has an effect on pain.
And although pain is generally not so much of a factor
in patients who are having lower blepharoplasty.
And more than 50% of my patients
who have lower blepharoplasty
do not need to use any analgesia or pain relief medicine.
Well, there is evidence
that in smokers your threshold for pain is reduced
and you can have more discomfort.
Having said that discomfort tends not to be an issue
in terms of blepharoplasty.
In addition to the, that of, in addition to the smoking,
well, there's been
some really interesting scientific evidence
looking at the effect of smoking on facial aging.
And one particular interesting study was based on twins
where identical twins, well, one twin had been a smoker
for greater than 10 years and the paired twin
had no smoking for about the same period.
But when they looked at the aging
of the smokers to the non-smokers,
well, the twins who smoke had considerably more aging.
And in the eyelids this resulted in more fine lines
and wrinkles, resulted in some natural volume lost,
natural fat, and overall the effects of aging
also affected skin quality and texture
and so the smoking group look considerably older
than the non-smokers.
And so, if you're going to do one thing
that would enhance your, your appearance and youthfulness
over a long period it would be to stop smoking.
The other element is the effects of smoking on general health.
And we know that smoking contains over 4,000 toxic ingredients
that can be harmful to the human body.
And really these effects of smoking
can affect every part of the body.
But particularly relevant to blepharoplasty
are effects on the skin and effect on healing.
But also on the chest and effects
on potential anesthesia choice
as well as increasing your risk of harm from other,
other parts of the body.
So, in addition to these factors,
well, we've looked to the effects of smoking.
We've looked to the effects on aging,
what advise do I give my patients regarding stopping smoking?
Well, I advise all my patients
who are undergoing lower blepharoplasty
to aim to stop smoking for 6 week period before.
And 6 weeks period after surgery
to ensure that they have the fastest possible healing
and the best possible natural looking result.
It is fair to say that the eyelids
are blessed with an incredible blood supply.
And this blood supply which is beautifully
described by Professor Von Hagen an anatomist
shows the intricate blood supply in network of,
of blood supply that supply the face and the eyelids.
And this intricate blood supply
actually protects your face in terms of healing.
Having said that if you're able to stop smoking,
then this would be the best possible advice
that I could give you is this will ensure that
you have the fastest possible healing
and reduces the effects of the scaring.
In addition to this, can I use nicotine patches to help me,
to help wean off the effects of smoking?
Well, unfortunately nicotine contains
the ingredients that affect blood vessels.
And the nicotine actually causes the blood vessels to narrow
which ultimately affects the way that oxygen is carried
to healing parts of the body.
So, unfortunately nicotine substitutes
are not a good alternative for smokers
and it is better to avoid both smoking and nicotine products
as both have a potential impact on healing and recovering.
The other aspect is vaping
and there's been a lot of discussion in the media
of the potential benefits of vaping over smoking.
And it's, its, it is true to say that smoking
has more toxic ingredients than vaping
and it s not going to affect your chest
in the same way that smoking does.
However vaping does contain some toxic ingredients
and at the moment we don't know the potential effect
of vaping in terms of healing.
And, and the potential effect
on delayed healing and recovery.
And so, this is largely unknown
and certainly there are benefits over traditional smoking.
However, the long term impact we don't yet know.
Vaping that contains nicotine products
have it can potentially be harmful.
And so, any kind of nicotine product
should be avoided before and after surgery
to ensure a fast recovery.
So, what can you do as a smoker
to potentially reduce the potential risks
and enhance your healing after surgery?
Well, the best advice I could give you
which is advice that I give to all my patients
who are smokers are to give you the best possible result
in terms of lower blepharoplasty.
You would be stopping smoking
at least 6 weeks before the surgery
and for 6 weeks after the surgery
to ensure you have the fastest possible recovery
and the best possible result.
In addition to that, the choice of anesthesia
can have an impact on healing
and my advice would be to avoid general anesthetic
and either have local anesthetic.
Sedation anesthesia as these will have minimal impact
on your general health and ensure that you have
a fastest possible recovery from lower blepharoplasty.
In additional there're certain parts
of the surgical technique that can be modified in surgery
in smokers in order to give you the best possible results.
And there are certain techniques that I would avoid
or change in smokers and these include fat transfer
because this can be unpredictable in smokers.
And I would also modify things like laser resurfacing
as this can impact healing.
Platelet-rich plasma is, it involves using
your own growth factors to heal parts of the body
faster after surgery.
And I personally would use
this technology platelet-rich plasma
in order to enhance your recovery if you're a smoker
in order to give you the best possible result.
So, in summary where we've talked about smoking
and the effects of smoking
both on lower blepharoplasty and eyelids.
We've talked about the effects on facial aging
and your general health.
And what I would personally advise patients to do
in terms of stopping smoking,
in terms of the effects of nicotine and the use of vapor.
And we ve also talked about factors
that can potentially enhance your recovery and reduce risks
if you're a smoker undergoing lower blepharoplasty.
I hope this information is being useful,
thank you for watching.