Introduction and aims
There are several studies in the literature suggesting that smoking increases the complication rate in various plastic surgery operations. We did a study on 402 patients to see the effect of smoking on breast reduction. The objective was to raise the controversial issue of whether breast reduction could be refused to smokers who fail to stop smoking in the peri-operative period.
Materials and methods
The records of patients who had undergone breast reductions between April 1999 and May 2004 at the Leicester Royal Infirmary, Leicester were reviewed retrospectively for age, body mass index, smoking habits and wound-related complications.
A total of 764 breast reductions were performed in 402 patients during this period. Twenty-eight per cent (112) of these patients were smokers. The mean age was 33.9 (range 19–68)+9.5 years in smokers and 34.4 (range 16–73)+10.6 years in non-smokers. About 90% of patients had bilateral breast reductions. Wound-related complications were seen in 35% of smokers as against 13% of non-smokers, P value<0.001. Overall, smokers had a 2.3×higher chance of developing a complication. The probability of a smoker developing wound infection was 3.3×more in comparison to a non-smoker. Smokers were also three times more likely to develop T-junction necrosis.
Smoking increases the complication rate of breast reduction significantly. Hence, patients must be strongly encouraged to quit smoking before surgery and abstain until the wound has completely healed. Stoppage of smoking in the peri-operative period should be adopted as an essential eligibility criterion for breast reduction.
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Published online: May 22, 2007
Accepted: January 15, 2007
Received: August 28, 2006
☆Work presented at the winter meeting of the British Association of Plastic Surgeons, 30 Nov 2005.
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.