The Impact on Mortality and Societal Costs From Smoking Cessation in Aesthetic Plastic Surgery in the United States

Abstract

Background

It is common practice to require patients to stop smoking prior to elective plastic surgery procedures. Scarce research exists describing the impact on mortality and associated societal cost savings with regards to smoking cessation in aesthetic surgery.

Objective

Our objective is to demonstrate that smoking cessation in anticipation for aesthetic surgery significantly reduces mortality reduction and societal cost savings.

Methods

We performed a systematic literature review of five common aesthetic procedures (reduction mammaplasty, breast augmentation, facelift, rhinoplasty, and abdominoplasty) to determine patient smoking rates and subsequent recidivism. Sensitivity analyses estimated life years saved using ranges of recidivism from our literature review and assessed total lifetime savings, including direct and productivity costs, while adjusting for inflation (3%) and interest (5%). One life saved was equated to 45 life years saved.

Results

Between May 2008 to May 2013, 7,867 patients stopped smoking prior to undergoing aesthetic plastic surgery procedures. Assuming a reported recidivism rate of 68%, smoking cessation prior to aesthetic plastic surgery is associated with 429 lives saved and a total lifetime savings of $524.4 million over the five-year period. Total lives saved ranged from 214 (84% recidivism) to 885 (34% recidivism), and total lifetime cost savings ranged from $262.2 million (84% recidivism) to $1.08 billion (34% recidivism).

Conclusions

Presently, smoking cessation before aesthetic surgery significantly saves patient lives with yearly $104.9 million of societal cost savings in the United States. Future reductions in the presently high recidivism rate would lead to additional lives saved and reduced societal costs.