Smoking and Breast Reduction

Reflectance confocal‐laser‐scanning microscopy in vivo assessments of cigarette‐induced dynamic alterations of cutaneous microcirculation on histomorphological level

“…We believe that this methodology is particularly suited for microcirculation studies, since reflectance CLSM opens a window onto living tissue and provides real time images of the microvascular network up to a depth of 350 lm. The influence of smoking on microcirculatory disturbances was previously described and controversly discussed (Cunningham et al, 2005;Parsa et al, 2006). Regardless of the fact that neither study designs, nor the volunteers investigated, nor the methods used were ever standardized and therefore allowed only limited comparison all studies concluded that smoking decreases the cutaneous blood flow.…”

“…Although invasive methods not only alter the original morphology but also always necessitate an iatrogenic trauma, other methods allow noninvasive investigation of the microcirculation. Whereas laser Doppler flowmetry is the most commonly described noninvasive technique to measure cutaneous blood flow, various other studies report the use of a plethora of other modalities such as thermography, pulse plethysmography, photoplethysmography, calorimetry, multilead plethysmography, pulse oximetry, and transcutaneous oxygen electrode measurements (Dalla Vecchia et al, 2004;Mehrara et al, 2006;Parsa et al, 2006;Rossi et al, 2007;Steenvoorde et al, 2007). None of these methods, however, allows observation of the microcirculation on a histomorphological level.…”

“…Whereas this technique was validated in the burn care arena for burn depth determination and in dermatology to visualize healthy skin morphology, photoadaptive processes, inflammatory conditions, and histomorphological patterns of skin lesions suspected of malignancy (Aghassi et al, 2000;Altintas et al, 2008a,b in press;Gonzalez et al, 1999a,b;Rajadhyaksha et al, 1999;Sauermann et al, 2002, Gambichler et al, 2006, it has not been used for the determination of dynamic processes of the microcirculation. The effects of smoking on microvascular network have been examined in a number of papers with both negative (Cunningham et al, 2005;Dalla Vecchia et al, 2004;Forrest et al, 1991;Riefkohl et al, 1986;Rossi et al, 2007) as well as no clear proof of smoking on microcirculation (Mehrara et al, 2006;Parsa et al, 2006;Steenvoorde et al, 2007). Most of these studies were carried out using various invasive (Forrest et al, 1991;Riefkohl et al, 1986) and noninvasive (Dalla Vecchia et al, 2004;Rossi et al, 2007) approaches.…”

A Modified, Direct Neck Lift Technique: The Cervical Wave-Plasty

“…Despite the fact that age, obesity, diabetes, hypertension and smoking are important comorbid factors in wound healing [ 15 ] we encountered only one case (3.1%) of wound dehiscence that occurred in a former smoker ( Table 4 ). Hypertension is another important comorbidity because of the potential for postoperative hematoma [ 16 ].…”

“…Over 40% gave a history of smoking, hypertension, or both. Smokers, including former smokers, have a higher risk of postoperative complications [ 14 15 ]. This higher incidence in this study is likely related to patient selection.…”