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Is it justified to refuse breast reduction to smokers?
J Bikhchandani1, S K Varma, H P Henderson
1Department of Plastic & Reconstructive Surgery, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK. jai_9c@yahoo.com
Summary
Smoking significantly increases breast reduction complications, including wound infection and necrosis. Smokers are over twice as likely to experience complications, highlighting the need for smoking cessation before surgery.
Area of Science:
- Plastic Surgery
- Surgical Complications
- Tobacco Use Research
Background:
- Studies suggest smoking elevates complication rates in plastic surgery.
- Breast reduction surgery is a common procedure with potential risks.
Purpose of the Study:
- To investigate the impact of smoking on breast reduction outcomes.
- To evaluate if smoking cessation should be an eligibility criterion for breast reduction.
Main Methods:
- Retrospective review of 402 patients undergoing breast reduction (April 1999-May 2004).
- Analysis of patient age, BMI, smoking status, and wound-related complications.
Main Results:
- Smokers (28%) experienced significantly higher wound complications (35% vs. 13%, P<0.001).
- Smokers had a 2.3x higher overall complication risk, 3.3x higher infection risk, and 3x higher T-junction necrosis risk.
Conclusions:
- Smoking substantially increases breast reduction complication rates.
- Strongly encourage peri-operative smoking cessation for optimal healing.
- Consider mandatory smoking cessation as an eligibility criterion for breast reduction.
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