Increased Risks from Breast Lift for Smokers?

I am a 46-year-old female and am thinking about a breast lift but my only concern is that I am a smoker and the actual surgery itself scares me. Because of me being a smoker, what would be the increased risks from this surgery?

Doctor Answers 11

Increased risk of skin death from smoking!

In a breast lift/reduction, a tummy tuck, or a facelift there is a considerable risk of skin death and massive wound healing problems and resultant permanent scars. This is because the nicotine constricts the blood supply to the skin that is being further compromised by lifting and tightening it. Nicotine gums, patches and even second hand smoke have the same effect. You need to be away from ALL nicotine products for at least one month before and another month after surgery to minimize the risk.

Seattle Plastic Surgeon
4.5 out of 5 stars 58 reviews

1135 116th Ave. NE
Bellevue, WA 98004

Smoking significantly increases the risks of breast surgery

Smoking causes constriction of blood vessels. Blood vessels provide blood and nutrition to the wounds while they heal. A breast lift operation requires many incisions. There is a tremendous amount of healing that must take place for a breast lift operation to heal well.

Smoking greatly interferes with healing. The risks of complications, such as infection, wound healing, poor scarring, opening of wounds, are signficantly increased by smoking.

Every surgeon is different. I personally require that patients quit completely for at least one month before their surgery. This is the only way I can be sure the patients will heal well.

You should discuss this in detail with your surgeon.

John Diaz, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 26 reviews

465 N. Roxbury Drive
Beverly Hills, CA 90210

Risks associated with smoking

Smoking is very detrimental to the recovery process following breast lift and other surgery. It compromises your immune system making your body less effective in fighting infection. It also hinders circulation making the recovery process slower. I usually recommend my patients stop smoking about four weeks before surgery. However, if you were smoke-free for three and only smoked one cigarette, you may be okay. Please ask your surgeon for their advice.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 108 reviews

362 Fairlawn Avenue
Toronto, Ontario M5M 1T6

Smoking and surgery

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

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 37 reviews

8900 Raintree
Scottsdale, AZ 85260

Increased risks from breast lift for smokers?

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 14 reviews

8900 E. Raintree Dr.
Scottsdale, AZ 85260

Breast Lift for Smokers?

Thank you for the question.

You should be free of any type of nicotine product  for at least 4 to 6 weeks prior to breast lifting 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 1,054 reviews

8851 Center Drive
San Diego, CA 91942

Breast lifts in smokers?

I strongly encourage you to quit smoking for 3-4 weeks prior to your procedure.  I agree with several of the other physicians that smoking prior to surgery can lead to devastating outcomes.  In general my patients are off of nicotine products and smoking for at least 3-4 weeks prior to a facelift, abdominoplasty and breast lift.  It is likely safer to have a heart bypass procedure in a smoker than to have an of the above stated procedures in terms of minor complications.

Christian A. Prada, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 138 reviews

17300 North Outer 40 Road
St Louis, MO 63005

Smokers and breast lifts

Smokers tend to have the highest complication rate.  I recommend to my patients to stop smoking 4 weeks before and the same amount of time post-op.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

1049 Fifth Ave
New York, NY 10028

Breast lift has increased risk for smokers.


There are several ways to do a breast lift, and some techniques we absolutely will not do on smokers in New York City. But even the safest techniques carry increased risk.

Some of our patients feel the best thing I did for them was getting them to stop smoking.

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

875 Park Ave at 78th Street
New York, NY 10075

No smoking

Hi Saggy Girl 46,

As others have answered, smoking comes hand in hand with problems.

You shouldn't be afraid of surgery .. it's the cancer stick that you should fear. There's no better feeling for me to nail it on a breast lift in a patient that has quit. Many use this as motivation so kick it and get going!

Good news and bad news ...

-the good news is that this is a great opportunity to quit smoking.

-the bad news is that if you don't quit, not only should you not get this surgery but you are at risk of developing lung cancer, emphysema, cardiovascular disease, etcetera. In other words, if you get this breast lift that means you quit .. so plastic surgery saved your life.

I've always been very interested in how many plastic surgeons out there do mastopexy on patients that smoke when polled at our national meetings. All I can say is that in the best interest of my patients (and in the interest of self preservation) I don't do this operation on smokers - especially with an implant. It's not like other surgeries where an incision is made, something is fixed up inside then it is closed (in case you had this and then healed up properly). In a breast lift, all of those tissues that you've seen slowly droop are separated and rearranged so that they're perky and tight once again. You need normal blood supply for this to heal and leave tiny lines behind.

This is your wake up call .. answer it!

Best Wishes,


Ricardo A. Meade, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 82 reviews

9101 N. Central Expressway
Dallas, TX 75231

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.