Smoking Hastens Eyelid Surgery: Visible Proof
A study published last fall in the Journal of Plastic and Reconstructive Surgery not only confirms what the medical community already knew about the effects of smoking on the face, it also illustrates the point with photos. In short, smoking brings about negative changes to facial skin that can hasten the need for facial plastic surgery including eyelid surgery.
A team of Cleveland-based researchers took advantage of the twins’ festival in Twinsburg, Ohio, over the course of three years, to study identical twins. The scientists included pairs in which just one sibling smokes, and pairs in which one twin smoked at least five years longer than the other
The researchers controlled for other factors that contribute to aging, such as alcohol use and stress. They also changed the position of the photographs so that the smoking twin’s picture appeared in different spots relative to his or her sibling. The plastic surgeons who analyzed the sets of photos then graded the signs of aging they observed.
The smoking twins’ scores were worse for facial wrinkles caused by the aging process (as opposed to wrinkles resulting from repeated motion, such as crow’s feet). Around the eyes, the team found that twins who smoked or smoked longer than their counterparts showed increased upper eyelid droop, one of the leading reasons men and women seek eyelid surgery, or blepharoplasty.
The evaluation team found evidence that smoking can drive patients to a plastic surgeon’s office for lower eyelid surgery consultations as well. Smoking twins in this study were more likely to experience bags and sags under the eyes as well as redundant skin of the upper lids. Not only that, smokers also had statistically worse scores for “malar bags,” also called “festoons.” These bulges occur at the cheek junction—lower on the face—and can be difficult to treat.
The researchers commented that smoking impacts the skin around the eyes because it suppresses the production of collagen and elastin—two substances that form a support network for surface skin. Smoking also provides a source of free radicals, which can impair skin’s repair processes, according to the team.
In our practice, one of the most popular procedures requested is eyelid surgery. In New York City, smoking is still a relatively common habit, and we can almost always tell when a new patient smokes or did smoke for many years—they tend to have more facial wrinkles than might be expected otherwise for their age.
We can and do treat smokers. We are happy to help them look and feel their best, just like all the other patients we are pleased to serve. But, as other responsible plastic surgeons do, we insist they stop smoking for a time before and after surgery to promote better healing. Since this is a must, and since the evidence of smoking’s impact on the face is now crystal clear through this study of twins, we suggest that there’s never a better time to quit than right now.
