Dr. Anthony Youn, M.D., is a plastic surgeon in Metro Detroit. He recounts one such incident in his new book "In Stitches":
Yes. Smokers who undergo breast lifts are at great risk of losing their nipples.
I’ve seen it before.
The nicotine in cigarettes and the carbon monoxide contained in cigarette smoke can diminish blood flow to various parts of the body. These toxins act as a virtual tourniquet. If the blood flow to a particular body part becomes greatly reduced or halted, that body part dies.
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 went medieval.
We used leeches.
Because of the mechanics of blood flow, when the blood supply is inadequate, which occurs with smoking, the tiniest veins often fail. This insufficiency results in a backup of old (venous) 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.
We use leeches to literally suck out the excess venous blood from the body part, acting as an attachable vein. The leech drains the old blood, causing it to turn from unhealthy purple back to healthy pink. We place leeches intermittently until the body part grows new blood vessels to do the leeches’ work. This can take several days.