Ask a doctor

Reschedule Breast Lift and Augmentation Days After Quitting Smoking?

I am having a modified breast lift with breast implants next Wednesday. I only stopped smoking 4 days ago; should I reschedule?

Doctor Answers (15)

Smoking and surgery

+1
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. 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 27 reviews

Reschedule breast lift and augmentation days after quitting smoking?

+1
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 mastopexy where the viability of the nipple-areolar complex is obviously important. Since the vascularity to the area is already tenuous since it will be raised by cutting around the area, maximizing blood flow to the tissue is critical.

Typically, we recommend at least 6 weeks of smoking cessation prior to any surgical procedure. Nicotine always increases the risk for infection, nipple necrosis, and wound complications, as well as other health consequences. 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

Best to stop two or more months prior to Breast Lift and Augmentation

+1

The quick answer is that you will lower your risk of complications if you stop smoking at least a few months prior to surgery so you might want to consider rescheduling. Another way of putting this is: "Tell me, do you feel lucky?"

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. For a tummy tuck there is increased likelihood of both an infection and loss of skin because of inadequate circulation.

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

You might also like...

Smoking before Breast Augmentation/Lifting?

+1

You should be free of any type of nicotine product  for at least 4 to 6 weeks prior to breast augmentation/ mastopexy surgery.  This holds true for other plastic surgical procedures that involve flaps,  such as facelift thing and tummy tuck surgery.

Nicotine behaves as a vasoconstrictor of blood vessels thereby decreasing blood flow to tissues ( that need to receive blood flow to heal after surgery).  A decrease in this blood flow may result in wound healing problems and/or tissue death.

I hope this helps

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 726 reviews

Smoking and lift

+1

I request that my patients stop smoking 3-4 weeks prior to surgery and delay restarting for another 3-4  weeks.

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

Minimum of 2 weeks without smoking before breast lift with breast implants.

+1

Hi.

In New York City, we really prefer that patients be smoke free for at least two weeks before having a breast lift with breast implants.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

It depends on the type of lift, but you should consider rescheduling!

+1

For breast implants, smoking may not be as much of an issue. The bigger issue is the lift. If it is a significant lift (repositioning the nipple), you are at risk for wound healing problems and losing the nipple! NOT WORTH IT! If it is a more minor lift, it likely won't be a big issue, but smoking may still worsen the appearance of the scars and make waking up after surgery rougher (more likely to cough, maybe higher risk of pneumonia). This is elective surgery and you want it to go as smoothly as possible, so rescheduling is the smartest thing to do! Good luck!

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 7 reviews

Smoking and breast surgery

+1

Patients should be off all tobacco products (inluding nicotine patches/gum) for a minimum of two weeks before and two weeks after cosmetic surgery. This risk of wound healing complications, poor scarring, nipple/areola skin loss is much higher in patients who smoke during(before/after) surgery. Also, with breast implants, there is higher risk of capsular contracture (thick scar tissue) developing in smokers.

The longer you can quit smoking, the better your chances of normal wound healing. You can always postpone elective surgery to improve your chances of getting a better result.

William Bruno, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 148 reviews

Smoking and elective surgery

+1

Yes you need to re-schedule. Smoking has a significant effect wound healing and will increase your risk of complications. This is elective surgery, it needs to be as safe as possible. Please tell your surgeon and re-schedule.

Different techniques of breast lifts have varying degrees of risk to blood supply and healing. Your surgeon should be able to advise you the proper length of time. There is no proven correct period of time to be smoking free. For most procedures i would recommend a minimum of 3 weeks. For some procedures that have an inherent increased risk it could be longer.

John E. Gross, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Smoking and Plastic Surgery

+1

Yes, you need to reschedule your surgery and let your plastic surgeon know.  You need to stop smoking atleast 2 weeks prior to your surgery if not 4 weeks.  Not even one.  Your complication rate is greatly increased as well if you continue to smoke.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 35 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.