Plastic reconstructive and esthetic surgery and tobacco, a legal approach

Tobacco is a supplementary surgical risk factor to which some of our patients expose themselves. A patient who smokes incurs a heightened risk of medical accident. This is now accepted scientific knowledge, and no currently practicing plastic surgeon can be unaware of the close connection between smoking and postoperative cutaneous healing complications. On this subject, surgeons are invested with a duty to advise. And when a patient continues to smoke, a physician can refuse to operate, except in the event of an emergency. In some cases, however, he can go ahead with the operation, provided that his analysis of the risk/benefit highlights the interest of the surgery for the patient, whatever may be the tobacco-related complications. It is nonetheless necessary that the latter be preliminary informed and that he or she knowingly accept the risk.