How do diet and smoking affect plastic surgery recovery?

Your surgery's done. The hard preop preparation is over. It's time to party, right? Wrong.

Without following your surgeon's aftercare instructions, you can – at a minimum – expect a longer and more uncomfortable road to recovery. And in the worst-case scenarios, serious, irreversible side effects, including necrosis, can occur.

The biggest aftercare offenders are smoking, along with an improper diet. We asked three renowned plastic surgeons and members of the American Society of Plastic Surgeons why, exactly, recovery rules need to be followed and the consequences if they are not.

Smoking

Oxygen won't get to the tissues

"The key to healing is oxygen delivery to the surgical area to promote optimal healing in a tissue," says Miami-based plastic surgeon Adam Rubinstein, MD. "Smoking affects healing in three different ways. Number one, you're putting gunk into your lungs and inhibiting good passage of gasses through the lungs."

Second, nicotine causes the constriction of the arteries all throughout the body, he says, which diminishes the blood flow at the tissue level, meaning that "the surgical area is not getting enough blood flow through there to carry oxygen because the nicotine is constricting everything."

"Number three, which a lot of people don't know, is that cigarette smoke contains carbon monoxide, and through its passage, permanently blocks the hemoglobin molecules from ever being able to pick up oxygen molecules," he says, which further diminishes the blood's ability to carry oxygen to the tissues where it's needed.

Recreational marijuana counts as smoking

"Pot is another issue," continues Dr. Rubinstein. "There are side effects of pot when it's mixed with anesthetics that can lead to arrhythmias. We prefer not to have anyone smoking any marijuana or consuming any marijuana – It's not even smoking, just consuming, whether it's edibles or smoking – for at least two weeks before surgery, but even better, more like a month."

Postoperatively, however, once anesthetics are completely cleared, usually within a few days of surgery, Dr. Rubinstein doesn't see an issue with edibles, although smoking of any kind is still off-limits for at least four weeks.

Diet

An anti-inflammatory diet can speed up recovery

"There are a lot of anecdotal accounts of patients postoperatively adhering to a more anti-inflammatory diet," says Manhattan-based plastic surgeon, Chris Funderburk, MD, who suggests integrating plenty of berries into a diet and avoiding heavy, fatty meats. "And we can tell you from a lot of the patients we see here in Manhattan that adhere to those diets, they report much-decreased inflammation, earlier recovery, basically overall faster return to just normal activity."

Salt equals more swelling

Of all the recovery diet no-nos, salt is number one on the list – for all types of plastic surgeries – as it will unquestionably increase swelling to a significant and visible degree. "Patients will mention they had a meal that was salty and the next morning, they woke up extra swollen," says Dr. Rubinstein. "High salt can lead to serious swelling that can extend recovery and just make it overall more uncomfortable."

Liposuction patients, in particular, need to be careful. New York City plastic surgeon, Ryan Neinstein, MD, puts his liposuction patients on a strict no-salt diet for four to six weeks postop. "Your body will retain water," he says. "Your body's like a sponge and salt will cause a huge amount of swelling or fluid accumulation. In some cases, it can shockingly lead to five to eight pounds of water weight overnight."

Going for bland food, as unappetizing as it may be, will save you a world of trouble in more ways than just swelling. An unpopular post-op fact is that for the few days after surgery, patients are going to be nauseous from the anesthesia. In more serious cases, it could be hard to keep food down and vomiting, although always unpleasant, could cause internal bleeding with facial procedures.

Alcohol – and ginger, turmeric and chia seeds – are blood thinners

Alcohol decreases the blood clotting cascade, which can result in additional bruising and internal bleeding. But unbeknownst to many patients, so goes ginger, chia and turmeric, including turmeric shots, which are ordinarily good for you, but are terrible around the time of surgery because it will thin the blood, putting you at risk of bleeding hematoma.

After about two weeks, once clots are healed within the body, Dr. Rubeinstein reassures patients that no food or supplement is off limits, although every surgeon in this story encouraged the continuation of a healthy, leafy diet.

It's not uncommon for patients to have questions about the recovery process post-surgery. Talk with your surgeon about an individual recovery plan that is right for you.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.