Alternative Ways to Quit Smoking to Preserve Your Breasts

Quit smoking to save breasts
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Smoking increases the risk of many types of cancer, including breast cancer. Unfortunately, for those who receive reconstructive surgery after mastectomy who continue to smoke, they risk losing their implants as well.

A new study by researchers at the University of Pennsylvania and Yale University finds that women who smoke face an increased risk for implant failure and loss within the first 30 days post-surgical reconstruction. Obesity also increases the risk.

Dr John Fischer, a plastic surgery resident from Penn, and a team of doctors analyzed post-surgery outcomes of 14,585 women between the ages of 40 and 60 who had undergone immediate breast reconstruction after mastectomy. Two variables – smoking and obesity – were already known from past studies to lengthen recovery time. The new research indicates that these two variables also increase risk of implant failure three times greater than in women who do not smoke and were of ideal body weight.

In addition, the team found that “the more severe the state of obesity, the higher their risk of this complication,” explains Dr. Fischer.

The overall risk is low – less than one percent of the patients in the study experienced the complication – however when stratified over the entire population, the research indicates that one in 25 women with one of the two variables could lose their implants.

Smokers are known to suffer a greater number of complications after any surgical procedure. For cosmetic procedures, patients are often advised to refrain from smoking for at least two weeks before and after the operation to assist wound healing. For breast reconstructive surgery specifically, there is some research to suggest that patients who have been smoking for longer than ten years should not undergo an operation as the risks are so high.

Smoking causes blood vessels to become small, which then affects their ability to carry oxygen, nutrients and healing factors to a wound. In addition, carbon monoxide from cigarette smoke enters the blood cells and lowers the level of oxygen in the blood. Smoking also lowers the amount of vitamin C which is necessary for healing.

Continuing to smoke during the months leading up to surgery can increase the risk of wound infection, cause longer and more expensive hospital stays, and increases the risk of blood clots.

Obesity has been shown to increase the risk of breast cancer as well. Excess body fat can increase the risk through factors such as insulin resistance, changes in the levels of hormones and through chronic inflammation. After diagnosis, obesity can negatively affect outcomes and survival rate. For example, there is a greater risk for infection and reduced healing after surgery.

Quitting smoking is admittedly tough. The first few weeks are probably the worst, but things do improve. The New York State Smokers’ Quitline offers these tips:

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1. Keep busy: When you distract yourself by doing something else, the urge to smoke may go away. Have a plan in place for “crisis situations.” For example, if you normally smoke after a meal, plan for a walk instead to keep you away from the cigarettes.

2. Use positive self-talk to help you through the tough times. Statements like, "I will not smoke no matter what," or "My body is telling me it is getting better," can help you master times of strong cravings.

3. Keep a reminder of why you are not putting that stuff into your body anymore. Create a picture board of the things that are important to you – being able to breathe during normal activities, being around longer for your family, having more money to do fun things, etc.

4. Don't forget the Five D's: Delay, Drink water, Do something else, Deep breathe, and Discuss your feelings

5. Most importantly, don’t worry about what it will be like without a smoke a month from now. Try to stay in the moment and focus on not smoking just for today. When you get up tomorrow, commit to not smoking for that day. The days will add up fast!

Medicines have been known to help, such as nicotine patches, lozenges, and gum. However there are some alternative therapies that may help as well.

• Hypnosis – hypnosis has become known for its ability to change behaviors quickly. It may also help relax your mind enough to identify unconscious triggers.

• Acupuncture – a technique derived from traditional Chines medicine, acupuncture uses tiny needles to stimulate certain points on the body. For smokers, the idea is to help reduce cravings and ease withdrawal symptoms. Common points of insertion include the ears, feet and top of the head.

Studies in both of these techniques have mixed results for whether or not they are effective, but both are considered safe, so they may be a good place to start your new non-smoking journey.

Journal Reference:
Fischer J, Wes A, Tuggle C, Serletti J, Wu L. Risk Analysis of Early Implant Loss after Immediate Breast Reconstruction: A Review of 14,585 Patients. Journal of the American College of Surgeons. 2013.

Additional Resources:
American Cancer Society, Breast Cancer Risk Factors
Action on Smoking and Health, Smoking and Surgery, July 2013
University of Wisconsin-Madison, Smoking and Wound Healing.

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