Why Do I Have to Stop Smoking for a Breast Lift?

I have had several surgerys in the past and healed just fine so why is a breast lift any different 2 doctors told me they would not have to move or down size my nipples if I do smoke what could happen

Doctor Answers (9)

Nicotine = blood vessel narrowing = distant tissue death and wound separation

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No medical condition in the history of the universe has profited doctors and undertakers more than Nicotine (and the hundreds of other toxins in cigarettes). Nicotine has been proven to directly or indirectly cause hundreds of diseases and conditions including, heart disease, PAD with loss of toes and feet, high blood pressure, COPD, asthma, bronchitis, lung cancer, skin damage, impotence etc etc.

When as Plastic surgeons we undermine a large area of the skin, we greatly depend on an intact circulation within that skin flap to continue carrying oxygen to the very edges and bring about healing. In smokers, the blood vessels are in a prolonged state of spasm and flow through the skin is poor. As a result, certain operations such as Facelifts, Tummy Tucks, Breast Lift, Thigh Lifts etc which depend on this circulation have poor if not disastrous results in smokers.

If you are unwilling to give up smoking to both look better and remain healthy, please, do not have the surgery. Do not lie to your surgeon or go to a surgeon who does not care about your smoking status - you may end up looking much worse.


Memphis Plastic Surgeon
5.0 out of 5 stars 58 reviews

Why do I have to stop smoking for a breast lift?

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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 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 11 reviews

Breast Lifting and Nicotine?

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Nicotine is constrictor of blood vessels,  decreasing blood flow to tissues that need to flow to heal after surgery. When plastic surgeons do operations that involve longer incisions and/or tissue flaps,  the blood flow to these areas become critical. Without the blood flow ( or a decreased blood flow secondary to the effects of nicotine) healing can be compromised and/or tissue may not survive.

For this reason, most plastic surgeons will not operate on patients who smoke within a time period prior to surgery (for specific operations such as facelifting, breast lifting, tummy tuck surgery etc.).

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 681 reviews

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Smoking and surgery

+1

Smoking should be stopped about 3-4 weeks prior to surgery and continued for 3-4 weeks after surgery until all wounds have healed.  Smoking increases complication rates by almost 50% as reported in some medical studies.

Steven Wallach, MD
Manhattan Plastic Surgeon
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Wound healing with smoking is like growing a plant without water.

+1

A breast lift requires lifting of the skin which limits the blood supply to the skin. The nicotine and carbon monoxide int tobacco smoke compromise the already limited blood supply making tissue death and wound separation at least 50 times more likely. Wound healing with compromised blood supply is like trying to grow a plant in the desert. It is in your best interests to stop smoking and shows that your surgeon is exercising good judgment.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

Smoking and surgery

+1

Smoking causes constriction of the blood vessels. In many surgeries this really does not matter much since there is usually an abundance of blood vessels feeding each area. However, in procedures like a breast lift where the surgery itself reduces the blood supply to the tissuse, smoking will reduce the remaining blood supply and can do so enough to cause enough decrease that the nipple or parts of the skin dies.

For this operation, continuing to smoke raises the risk of tissue (including nipple) loss 20 fold. Most Plastic Surgeons are not willing to take this chance, even if you are.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
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Smokers have increased risk of wound complications when undergoing cosmetic surgery

+1

Smoking and chemicals in cigarette smoke tighten small blood vessels and decrease blood flow to healing tissues. A breast lift involves cutting the breast and skin and moving the nipple to a higher position on the breast.  Blood supply is partially cut during this procedure so healing depends on the adequacy of the blood flow left behind.  Cigarette smoking increases the risk that this blood supply will not be adequate, increasing the risk of wound breakdown, nipple loss and loss of breast tissue and skin. Breast lift is a non medically indicated surgery, and as such, should be done only when risks of complications are minimal. I am glad that there were no complications with your previous medically indicated surgeries, but you were lucky. Smoking may increase the risks of elective surgery to unacceptable levels. I would counsel you to quit before surgery just as your surgeon has already done.

Elizabeth Slass Lee, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 32 reviews

Smoking and plastic surgery carries specific risks

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Breast lifts, tummy tucks, and facelifts all have something in common which is underminig the skin and pulling it into a new position. These 2 factors put strain on the blood flow to the skin, and if you add a blood vessel constrictor drug such as nicotine the blood flow to that area can shut down completely. The result is dead tissue, which can be a horrendous problem. Surgeries that don't involves this sort of extra strain on blood circulation to the skin in the surgical site can heal OK in smokers. But in the case of a breast lift, it is a specific and unacceptable risk. An analogy I like to use is crossing the street when there is traffic; with smoking it is like stepping out in front of an oncoming truck instead of waiting for the green light (quitting smoking.)

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 23 reviews

Breast lifts and smoking

+1

There are a lot of toxic chemical is cigarette smoke, but the nicotine is one of our big worries.  It causes narrowing of the blood vessels in your body, including the ones carrying blood to and from the nipple.  During a breast lift, the blood supply to the nipple can be stressed, and if you are smoking as well, then there is a risk that the nipple will not have an adequate blood supply and could die.  For this reason, many of us ask patients who smoke to stop doing so for at least 6 weeks before and 6 weeks after the surgery to allow everything to heal properly.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 91 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.