Smoking Before Breast Augmentation Lead to Major Complications?

Hello, im having Breast Augmentation on Tuesday, November 17, 2009. I have smoked 10 cigarettes during the 2-week period, 4 in the past 6 days. Leading up to my surgery will this lead to major complications?

Doctor Answers (16)

Smoking and breast implant surgery

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Smoking prior to any plastic surgery procedure can lead to complications such as infection, poor scarring, capsular contracture (hard scar tissue) and wound healing problems, to list a few. It is recommended to stop smoking approximately 2-8 weeks before and 2-8 weeks after your elective surgical procedure. You should also avoid being around other people who smoke during the perioperative period (second hand smoke).

If you have smoked the week leading up to your surgery, I would inform your plastic surgeon and consider rescheduling your procedure.

Best wishes,

Dr. Bruno


Beverly Hills Plastic Surgeon
5.0 out of 5 stars 144 reviews

Smoking and surgery

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In some studies, smoking leads to a 50% increase in the complication rate of almost any surgery.  Breast augmentation although not as problematic as some other surgeries like tummy tucks or facelifts, can still have major complications from cigarette smoking.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Smoking and Breast Augmentation

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Smoking increases risks for all surgery, but some more than others. With breast augmentation, the problems are more pulmonary than related to healing. I personally do not have a big problem performing BA in a smoker. I will not, on the other hand, perform tummy tucks, breast reductions, or facelifts in the usual fashion on active smokers.

John Whitt, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

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Smoking and surgery

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Here are the major points of smoking Tobacco or Marijuana before or after surgery:
1. There is nicotine in tobacco, but not in marijuana. However, most joints are rolled with marijuana and tobacco combination. Nicotine is a vasoconstrictor that decreases blood flow to the tissues. This is the major problems that can cause a very bad outcome in some surgeries. In a breast augmentation, there is not a lot of risk as there are not a lot of incisions which decrease blood flow to the tissues. In a breast lift or tummy tuck, on the other hand, there is much longer and more involved incisions. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die. This can cause part of the breast or nipple, or in the case of a tummy tuck, part of the belly tissue to die, resulting in a very bad outcome. Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion.
2. There is carbon monoxide in both tobacco smoke and marijuana smoke. Carbon monoxide decreases the oxygen carrying capacity of hemoglobin in the blood. This is different from the vasoconstrictor effect, but has the same result of having the risk of tissue death in conjunction with surgeries that decrease the blood flow to tissues such as breast lifts and tummy tucks, as opposed to an augmentation alone that does not decrease blood flow to as great of an extent. Again, edible forms of marijuana do not have smoke, and thus carbon monoxide poisoning.
3. Coughing. Both tobacco and marijuana smoke disrupt the lining of the lungs and bronchi and can lead to coughing episodes. Coughing episodes can lead to internal bleeding after surgery that can lead to hematomas and complications, and again a bad outcome. Again, edible forms of marijuana does not have this effect.
4. Anesthesia effects. Marijuana can have drug interactions with certain anesthetic drugs. Thus it is important to tell your anesthesiologist about your marijuana use.
In conclusion, Smoking, whether it be tobacco or marijuana, is detrimental to your surgery outcome. Edible marijuana is much less so, but be honest about your use with your surgeon and anesthesiologist so that you can have the best outcome. In general, you should quite smoking many weeks, ideally 6 weeks before surgery, and not smoke for at least 2 weeks after surgery.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 27 reviews

Smoking before breast augmentation lead to major complications?

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Hello! Thank you for your question! The issue with nicotine is that it also acts as a vasoconstrictor, clamping down of blood vessels. Blood supply is always of great concern during any surgical procedure, but especially in such a procedure as a breast augmentation where the viability of the nipple-areolar complex is obviously important. Since the vascularity to the area is already tenuous with placement of the implant beneath, maximizing blood flow to the tissue is critical.

Typically, we recommend at least 6 weeks of smoking cessation prior to and at least 6 weeks after any surgical procedure. The longer, the better. Nicotine always increases the risk for infection, nipple necrosis, and wound complications, as well as other health consequences.  The most devastating consequence of infection, especially since an implantable prosthetic device is used, is increased. This along with wound healing and scarring. I would discuss this with your surgeon prior to your procedure. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Smoking Leads to Major Complications

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Cigarette smoke contains carbon monoxide that reduces the ability of the red blood cells in a smoker's body from transporting oxygen throughout the body. The presence of carbon monoxide in the blood is reduced by half when no cigarettes are smoked for four hours and, better yet, is reduced to a safe level if cigarettes are avoided for eight hours. Stopping smoking before and after surgery helps oxygen to more effectively travel throughout the body, an essential tool in warding off infection and successful wound healing. You may have seriously compromised your recovery rate by smoking.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 56 reviews

Smoking before breast augmentation and complications

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As you can imagine, smoking is bad for breast augmentation, (and surgery in general). Most would say that you have a significantly higher rate of wound complications. When one takes a drag on a cigarette, the chemicals cause vasoconstriction. Wound healing is all about getting blood flow and oxygen to the tissue. I believe that you will find that each doctor may have a different opinion as to how long you need to be off cigarettes. Some will test for nicotine in the system. Best to talk with a board certified plastic surgeon. Also best to quit smoking, (for a variety of other health reasons as well).

Jeffrey Roth, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 7 reviews

Smoking Before Surgery Increases Risk

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Chances are that you will do fine, but the more nicotine you consume by smoking the more risk you put yourself in. Other factors also add up such as being overweight, on Birth Control Pills or hormones, or if you have a medical condition that causes hypercoagulation.

Most experts unanimously agree that smoking increases the rate of  breast augmentation surgical complications significantly. Just about all plastic surgeons strongly recommend  women  to stop smoking and all nicotine products well in advance of breast augmentation with breast implants.  Many plastic surgeons recommend stopping all tobacco products several months prior to surgery.A scientific article in the Archives of Internal Medicine indicated that, among all forms of surgery, quitting smoking eight weeks prior was never associated with an increased risk of complications.

Here is the reason why: the nicotine in cigarettes and other tobacco products (including Nicorette gum, patches, etc) is a vasoconstrictor, meaning it makes the Smoking is a significant multiplier of many potential complications following surgery and breast augmentation with implants are no exception. Nicotine from smoking causes blood vessels to vasoconstrict ( tighten up). Over time, these constricted arteries and capillaries deliver less blood to the breast tissue which is needed for normal healing. Smokers therefore have an increased incidence of higher likelihood of complications such as infection, and in particular capsular contracture (hardening and distortion of the implants). General complications of surgery such as blood clots, anesthetic problems such as pneumonia are also increased.

 

In young patients you will probably statistically avoid these complications, why tempt fate by increasing your odds that something bad will happen.On a long term basis, smoking also causes accelerated aging of the skin and loss of elasticity. Hopefully these reasons will help give you the will power and courage to stop smoking.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 45 reviews

Don't smoke if you want a breast augmentation

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Smoking is associated with necrosis of the skin, poor wound healing, unsightly scar formation---not to mention lung cancer.  Be honest with yourself and with your plastic surgeon.  If you are a smoker, consider a smoking cessation program and then reward yourself with the surgery that you've always wanted.  Don't assume that you will be the patient who will escape these complications because nicotine is an equal opportunity punisher.  Also, know that smoking is implicated in premature aging of the skin so, if you stop, you will be less likely to need facial rejuvenation surgery and, if you elect to have that surgery, will be a much better candidate.  Wishing you every success in overcoming this problem and leading a long and healthy life!

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 11 reviews

Smoking and surgery

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Due to the increased ricks and healing concerns, I ask all of my patients to cease smoking at least 4 weeks prior to surgery. Hopefully, after the patient has quit for four weeks, they will become permanent non-smokers. The end goal is a safe and successful surgery. Best of luck! 

Christine Sullivan, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.