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?
Increased Risks from Breast Lift for Smokers?
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.
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.
Risks associated with smoking
Smokers are more likely to experience breathing problems following surgery than non-smokers (40% compared to 11%) because tobacco smoke damages the lining of the lungs. When the lungs are compromised, they are less efficient in clearing away waste (secretions and particles). This, coupled with the decreased efficacy of a smoker's immune system, can lead to post-operative infections and/or pneumonia.
The nicotine in cigarettes affects nervous systems, leading to faster heart rates (heart stress) and high blood pressure. Combined with the carbon monoxide present in tobacco smoke, a substance that reduces the body's ability to transport oxygen to the heart, smokers become much more susceptible to heart attacks (at a rate of 80% higher than non-smokers). Heart stress is also much more commonly witnessed by anaesthesiologists.
A smoker's compromised immune system leads to a rate of post-operative wound infection that is six times higher than non-smokers.
Fortunately, patients who stop smoking before surgery are able to protect themselves from many of the complications that can occur during their procedure. Taking this precaution reduces surgical risks and may help create a more successful treatment outcome.
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.
If patients do not stop smoking for at least 4 weeks before surgery, their surgery may be rescheduled.
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Smoking and 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.
Pablo Prichard, MD
Increased risks from breast lift for smokers?
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!
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.
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.
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.
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.
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!
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.