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, I’ve seen it before.
In my memoir “In Stitches,” 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 used leeches to the old blood, causing it to turn from unhealthy purple back to healthy pink.
When the blood supply is inadequate, which occurs with smoking, the tiniest veins often fail. This insufficiency results in a backup of old 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.
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.
And do you really want me to reach for the jar of leeches? Smokers, you have been warned.
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