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osoab
5th December 2011, 02:51 PM
Smoking can make your nipples fall off (http://thechart.blogs.cnn.com/2011/12/05/smoking-can-make-your-nipples-fall-off/)




Anthony Youn, M.D., is a plastic surgeon in Metro Detroit. He is the author of “In Stitches,” (http://www.institchesbook.com/) a humorous memoir about growing up Asian American and becoming a doctor.
http://i2.cdn.turner.com/cnn/2011/images/07/06/tzleft.youn.anthony.courtesy.jpg

I cringe every time I see a patient for a breast lift who is a smoker. I’m deathly afraid that despite my warnings, she will smoke before or after surgery and cause her nipples to turn black and fall off.

Yes. Smokers who undergo breast lifts are at great risk of losing their nipples.
I’ve seen it before.

The nicotine in cigarettes and the carbon monoxide contained in cigarette smoke can diminish blood flow to various parts of the body. These toxins act as a virtual tourniquet. If the blood flow to a particular body part becomes greatly reduced or halted, that body part dies.

In my memoir “In Stitches (http://www.institchesbook.com/),” I told the story of a smoker whose nipples turned purple while undergoing a breast lift surgery. Purple is the precursor to black. Black is the precursor to falling off. To save the patient—and her nipples - we turned to the only treatment available.

We went medieval.

We used leeches.

Because of the mechanics of blood flow, when the blood supply is inadequate, which occurs with smoking, the tiniest veins often fail. This insufficiency results in a backup of old (venous) blood in the body part, causing it to turn purple. If the backup of old blood is serious enough, the purple color may eventually turn black. That’s when we know the body part - toe, finger, or nipple - is dead.
We use leeches to literally suck out the excess venous blood from the body part, acting as an attachable vein. The leech drains the old blood, causing it to turn from unhealthy purple back to healthy pink. We place leeches intermittently until the body part grows new blood vessels to do the leeches’ work. This can take several days.

Not long ago, during a consultation for a breast lift, a patient, Susan, admitted to being a pack-a-day smoker. I informed her that smoking can cause difficulty in healing and instructed her to quit smoking at least one month before surgery and to stay off cigarettes for at least a month afterward. Several months later, when she arrived at the hospital for her breast lift, she smelled like an ashtray.

“Susan, I thought you quit smoking.”

“I did. OK. For a while. It’s really hard to quit, Dr. Youn.”

“I know,” I said. “But this is a big deal. There could be major healing problems if you smoke before or after surgery.”

“I understand. But I want to go ahead with the surgery anyway. It’ll be fine.”

She wasn’t hearing me. I needed to get through to her. “Susan, listen to me. If I operate on you, your nipples could turn black and fall off.”

Her eyes widened. “You mean… I’d have no nipples?”

“No nipples. That’s what smoking can do.”

Susan flushed. She raised her voice. “Dr. Youn, I took a week off work for this surgery. I had to put my whole life on hold for an entire week. If you told me I’d lose my nipples from smoking, I would’ve quit for good. This is your fault.”
Yes. Seriously. Susan blamed me for the inconvenience.

Thanks to her, I’ve changed my policy. In addition to the Surgeon General’s Warning that appears on cigarette packages, I now offer the Plastic Surgeon’s Warning to all my patients who smoke: If you are having a breast lift or reduction and you smoke, your nipples could turn black and fall off. If you are having a tummy tuck and you smoke, you may get an infection resulting in a big gross open wound that will take three months to heal. If you are having a facelift and you smoke, the skin of your cheek could turn black and slough off, leaving exposed fat.

Imagine yourself looking like “Two-Face” from “Batman: The Dark Knight.”

And do you really want me to reach for the jar of leeches?

Smokers, you have been warned.

Glass
5th December 2011, 05:38 PM
thats fair warning. stay away from plastic surgeons.

Joe King
6th December 2011, 06:25 AM
So a years old daily activity was to blame for the sudden nipple problem? Not the day before getting her nipples cut 3/4 off to stuff large plastic bags behind it?
::)
Even in his denial the truth can't be hidden much:

What he's saying is that it interferes with healing.
ie when the bloods O2 carrying capacity is reduced, the rate of healing from any injury, be it natural or manmade, is also reduced.

LuckyStrike
6th December 2011, 07:54 AM
All I know is smoking is evil like Hitler, at least that's what I was taught in gubmint skoo.

This same prick undoubtedly gives out all sorts of pharmaceuticals to his patients and those are completely safe I'm sure.

keehah
6th December 2011, 11:27 AM
What he's saying is that it interferes with healing.
ie when the bloods O2 carrying capacity is reduced, the rate of healing from any injury, be it natural or manmade, is also reduced.

I think its more the capillary restriction effect of smoking, the ability to get blood past the Doctor's damage.

But you missed my point of the earlier post, the Doctor spins things to divert responsibility, for 'blaming the victim' if his operation goes wrong.

A less 'projecting risk to the victim' explanation could be:

If I operate on you, [and you are still smoking] your nipples could turn black and fall off.”

Her eyes widened. “You mean… I’d have no nipples?”

“No nipples. That’s whats my operation could do.”

I expect nipples turn black and fall off in non-smoking breast implant patients a week after a breast nipple operation, at a higher rate than in the average week of the average female smoker without the operation.

The Doctor should also be aware of, and take into account how few people manage to quit smoking in such situations in his position over his patient.

Joe King
6th December 2011, 11:43 AM
I think its more the capillary restriction effect of smoking, the ability to get blood past the Doctor's damage.

But you missed my point of the earlier post, to rephrase the Doctor without also 'blaming the victim':

If I operate on you, [and you are still smoking] your nipples could turn black and fall off.”

Her eyes widened. “You mean… I’d have no nipples?”

“No nipples. That’s whats my operation could do.”I understand your issue with the surgery, but it's something the patient is electing to undergo. You make it sound as though the Dr is doing it to people who don't want it.
ie it comes down to the patients Right to decide for themselves as to what happens to their body. The Dr is merely informing about potential complications that could be a result of the patients lifestyle.

It also is a reflection upon the regulatory system that most have placed themselves under, in that the gov has decided for you and written into the regulations that the procedure mentioned is permissable for you to have done if you so choose.
ie your Right to choose has been granted by the gov, and can be modified or removed altogether.



I'd also assume it's probably both the capillary restriction as well as reduced O2 carring capacity. If there is elevated CO levels along with all the stuff delivered by a cig, it has to displace O2 that could be there in its place, and if its also harder to get it to the wound, its like double plus bad. lol
ie more O2 means faster healing.

Joe King
6th December 2011, 12:24 PM
Since you bring up willingness of the victim,....

How can you say she's a victim? She's exercising Right that's been bestowed upon her by gov decree.
...and if her own lifestyle choices can cause complications, it's the Drs duty to inform. If the Dr didn't inform and her nipples fell off, then he could potentially be liable.

As far as the surgery itself, how you personally feel about it is irrelevant.

lapis
7th December 2011, 01:39 AM
Not long ago, during a consultation for a breast lift, a patient, Susan, admitted to being a pack-a-day smoker.

Here we go, yet another negative anecdote about that seemingly ubiquitous pack-a-day smoker who smells...wait for it...like an ashtray (I know, how original, right?).

Why are there never any anecdotes or studies about the ones who only smoke half a pack a day, or three on Tuesdays or two cigarettes every other day?

Will only half or a third or a quarter of their nipples fall off during breast-lift surgery, depending on the amount smoked? Can it be reduced to an elegant mathematical formula? How many Montgomery glands can dance on the head of a pin?

"They" make it sound like all smokers are like....out-of-control heroin addicts or something (http://fashionindie.com/kate-moss-smokes-100-cigarettes-a-day/).

Although come to think of it, it will be a while before Kate Moss has to worry about needing a breast lift (https://lh6.googleusercontent.com/-kIw9WgYKq_w/TX_H1-6vpWI/AAAAAAAAAJw/PpYpNM9wS98/s1600/13+kate+moss+corinne+day.jpg).

Which is a good thing, because an ass of a doctor like the good Anthony Youn would cringe and whine and admonish and show what an utter humanitarian he is when he relates the trite "smoker who won't listen to the doctor, tisk tisk!" story to the public.

mamboni
7th December 2011, 06:10 AM
Some of the reactions on this thread astound me.

The nicotine and carbon monoxide in tobacco smale compromise the blood supply to the breast skin - this is basic medical physiopathology. The cosmetic procedure also compromises the blood supply to the breast - a known risk. So smoking when having a breast implant inserted is asking for big trouble.

Perhaps the doctor didn't explain these risks to the patient well enough. The patient seems to be too determined to get the breast implants and in denial about the risks. Obviously, a pack a day smoker is not going to stop smoking to have the surgery - at least not your ordinary smoker. Smoking is extremely pleasurable and addicting - only people who have smoked fully appreciate this. It is difficult to determine when "informed consent" has been accomplished. I've seen patients get explanations of procedures six ways to friday, only to claim that they didn't understand the risks after something goes wrong. This is why doctors spend so much time documenting what they discussed with the patient.

As for this surgeon, I think his only failing is willingness to operate knowing that the patient is not prepared properly. If it were me, I would have told the patient " Sorry, no surgery until you stop smoking! It's too risky and an unnecessary risk at that. And I may want a urine cotinine test result before surgery - in a month!"

Personally, I think patients who have this mutilating surgery are nuts. But, it's a free country and as long as folk are willing to pay for it there will be 'doctors' happy to provide the service.

lapis
11th December 2011, 01:41 AM
As for this surgeon, I think his only failing is willingness to operate knowing that the patient is not prepared properly. Are you surprised? It seems like if it weren't for patients like this (ones who smoke a pack a day and don't take care of their health and perhaps cause their breasts to sag due to these issues), plastic surgeons wouldn't have that many people to operate on and make money off of.
If it were me, I would have told the patient " Sorry, no surgery until you stop smoking! It's too risky and an unnecessary risk at that. And I may want a urine cotinine test result before surgery - in a month!" Well you obviously have higher standards than doctors like this, and really care about your patients' well-being enough to demand a nicotine test. I wonder why Dr. Youn can't? It's a reasonable request. He must not care as much as you do, and/or doesn't want to lose the income.

keehah
11th December 2011, 02:05 AM
Are you surprised? It seems like if it weren't for patients like this (ones who smoke a pack a day and don't take care of their health and perhaps cause their breasts to sag due to these issues), plastic surgeons wouldn't have that many people to operate on and make money off of.
Better to blame 'cancer curing' run events and those actively 'taking care of their health' for the sagging breasts. ;D
http://www.007b.com/sagging.php

When breasts bounce during active sports, such as tennis, those ligaments can also be stretched or even torn.

...Worries about sagging breasts is one of the most popular questions sent to this website.

lapis
11th December 2011, 03:08 AM
Better to blame 'cancer curing' run events and those actively 'taking care of their health' for the sagging breasts. ;D

http://www.007b.com/sagging.php

It's surprising that most of the pictures of saggy breasts belong to young women.

There's a lot of interesting information, but I seriously, seriously doubt these statements:

"However, the idea that bras would prevent sagging in general is a myth (http://www.007b.com/bra_sagging.php). For most of us bra wearing can actually increase sagging! This sounds strange, perhaps, but it is based on a few scientific studies. The idea is that when you wear bras, those ligaments inside breasts can atrophy and shrivel away from non-usage. "Use it, or lose it" seems to be at work. The gentle bouncing of breasts when you walk and move can help those ligaments stay in top shape. Perhaps breasts weren't meant to be kept totally "jiggless" and motionless!"
Oh yeah? Then why are all those documentaries of native peoples filled with women who don't wear anything and they have long saggy breasts? They're called "jungle boobies" for a reason. Long live the underwire bra!

But I agree with this:

"One other thing you can try (I'm not guaranteeing any results) is to help the elasticity of your skin nutritionally. Maybe that would help those ligaments to stay in top fit and to prevent further drooping. For example, vitamin C is very important for the collagen synthesis within skin. There are also other vitamins, minerals, and nutrients that can help the skin and ligaments to be in top health."