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How Long Should You Stop Smoking Before Tummy Tuck?

Doctor Answers (17)

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. This is especially bad in breast reductions or face lifts. Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion. Vaporizers do not decrease the amount of nicotine in tobacco, only decrease the smoke.
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


Phoenix Plastic Surgeon
5.0 out of 5 stars 26 reviews

How long should you stop smoking before tummy tuck?

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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 tummy tuck where the viability of the belly button and skin flaps are obviously important. Since the vascularity to the area is already tenuous with the dissection of the abdominal tissue as well as cutting around the belly button, 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, skin flap necrosis, and wound complications, as well as other health consequences. There is an increase pulmonary risk with the anesthesia and postop lung infections. The most devastating consequence of infection, especially since the tissue is tightened, 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 11 reviews

Smoking and Abdominoplasty

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The scientific data is clear that smoking is quite risky in patients having a tummy tuck.  Most plastic surgeons, including myself, require that you have no exposure to any tobacco/nicotine containing products for 4 weeks prior to and an additional 4 weeks after having the surgery.  Compromised normal blood flow in an abdominoplasty patient (via nicotine products along with thousands of other harmful chemicals in cigarettes) can at times lead to disastrous complications and significant/permanent scarring and pain.  You are having the surgery to improve your looks, so don't set yourself up to potentially make your tummy look worse!  Best wishes!

Brian Howard, MD
Alpharetta Plastic Surgeon
4.5 out of 5 stars 18 reviews

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Tummy Tuck

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Smoking has a significant effect on bloodflow.  It is particularly important with surgery such as tummy tucks because the abdominal skin flap needs the blood supply to effectively heal the abdominal flap incision.  I tend to be very cautious in smokers when I do these procedures.  I prefer patients to stop smoking for one month and to be off all aids such as nicotine gum (the gum puts some of the compromising substances into your system that effects blood supply.)  In addition, I am also a bit more conservative in the "tuck" portion of the procedure to avoid too much ension on the tummy skin as I have noticied that even smokers who quit for one month preop have a slower healing of the incision skin edge.  I hope this information is helpful for you.

Ronald H. Stefani Jr, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 2 reviews

Be Tobacco Free Before Surgery

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The use of tobacco products is extremely detrimental to the surgical process. Not only can tobacco use impair ones ability to heal incisions, but it places patients at much higher risk for other peri-operative complications such as atelectasis, pneumonia and deep venous thrombosis. It is essential that patients be COMPLETELY off all tobacco products, including nicotine gums and patches, for an absolute minimum of six weeks prior to surgery...and for as long as is required to be completely healed after surgery.

Kevin Brenner, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 15 reviews

Two weeks before and two weeks after of nonsmoking is recommended, but not always possible.

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A common recommendation is no smoking one month before and then one month after surgery.  However, I shorten this to two weeks for my patients because I know that it is a very difficult thing to quit and I'd rather them concentrate on no smoking for two weeks before and after rather than cheating during a longer period.  Some surgeons are very strict and won't even operate on patients who smoke.  I do not fell this way.  I tell my patients that their risk of delayed wound healing is increased if they smoke.  Tummy tucks are such an effective procedure that even if a patient has a wound that takes a few months to heal and leaves more scar tissue, they are still glad they did it.  I discuss this on my website (link is attached).  During surgery, I keep as much vascular supply to the skin flap as possible, particularly in smokers.  Remember, nicotine causes the little blood vessels to constrict, so using nicotine gum is not a good option.

Of course, it would be great if you could use this surgery as a new start on a healthier lifestyle and plan on quitting smoking at the same time.  You may find your confidence level is higher after the tummy tuck.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.5 out of 5 stars 34 reviews

Smoking and tummytuck

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I ask my patients to be nicotine free for at least 3 months prior to a tummy tuck procedure.

This also applies to facelifts, breast reductions and breast lifts.  The effects of smoking a single cigarette will last 8-10 hours on the microcirculation.  These are the tiny blood vessels that bring oxygen to the tissues.  A lack of oxygen can cause tissue necrosis (death of tissue).

Daniel H. Kane, MD
Miami Plastic Surgeon
5.0 out of 5 stars 1 review

Smoking cessation before tummy tuck

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The longer, the better!  I would recommend that you go through a smoking cessation program at least eight weeks prior to abdominoplasty.  Nicotine has longterm effects and interferes with wound healing so smoking can truly be adverse to the surgical outcome.  Wanting a tummy tuck can be an excellent motivation to quit.  I encourage you to speak with your doctor and find a program, whether hyponosis, Nicorette or another treatment, which will help you to be smoke-free!

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

Stop Smoking before a Tummy Tuck

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I would stop the smoking, nicotine gum, and any nicotine patches for AT LEAST 4 weeks prior to surgery.  The nicotine will constrict blood vessels and may cause the blood supply to be weakend to the healing areas which can increase the wound complication rate.  It is just not worth taking a chance with elective surgery.  This advice is my recommendation prior to tummy tucks, facelifts, breast lifts and reductions, arm lifts, thigh lifts, and body lifts.

Christa Clark, MD, FACS
Sacramento Plastic Surgeon
5.0 out of 5 stars 35 reviews

Smoking before tummy tuck

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The longer the better.

You not only need to stop smoking for the period of time recommended by your plastic surgeon, you also need to be off any other form of nicotine, which is the culprit.  You must be off any nicotine containing gum or patch etc.

Don't cheat.

Good luck

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.5 out of 5 stars 23 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.