How Long Before Surgery Should I Stop Nicotine Replacement Therapy?

I quit smoking almost a year a go. Recently, I've been going through stress and had the urge to smoke again. Instead of smoking, I started back on NRT. I use the Nicorette lozenges, about 3-4/day. How soon before surgery should I stop?

Doctor Answers (14)

NRT and Mommy Makeover Surgery


Since you asked the question, you must be aware that smoking increases the risk of some complications for surgery including wound healing. Congratulations on quitting almost a year ago! Available evidence does not support a detrimental effect of NRT in surgical patients, especially when compared with the consequences of continued smoking. However, I advise my patients not to take anything other than vitamins prior to surgery. I like to see them avoid anything unnecessary for two weeks before and two weeks after surgery. Good luck.


San Francisco Plastic Surgeon
4.5 out of 5 stars 28 reviews

Stop Smoking and NRT 8 weeks before Mommy Makeover


Generally Plastic Surgeons recommend stopping all forms of Nicotine 5 weeks before surgery.

However Mommy Makeover is a "Multiple Procedure" operation which carries increased post operative risks and I prefer that all forms of Nicotine be stopped 8 weeks before Mommy Makeover Surgery.

I also recommend doing blood tests to check for Nicotine metabolites in the blood before surgery.

The Mommy Makeover typically includes a Tummy Tuck, and Breast surgery either Breast Augmentation, Breast Lift or both. These multiple procedures involve creating skin flaps which lessen the blood supply to the skin.

Since Nicotine causes spasm of blood vessels and reduced blood supply to the skin, the effects of Nicotine can be very risky during Mommy Makeover surgery

Brooke R. Seckel, MD, FACS
Boston Plastic Surgeon
5.0 out of 5 stars 26 reviews

Nicotine cessation

I recommend no nicotine for two weeks prior to and two weeks after surgery. Nicotine causes your blood vessels to squeeze down, which decreases the oxygen available to your tissues for healing. I commend you for going back to lozenges instead of smoking. It's a tough habit to kick - congratulations.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 66 reviews

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Nicotine and Surgery


Nicotine causes vasoconstriction of blood vessels which results in decreased blood flow to the skin. Any procedure that requires the elevation of skin flaps can be adversely impacted by this phenomenon. For this reason we generally recommend that patients not use nicotine products for four to six weeks prior to surgery. This includes cigarettes, nicorette gum, patches or anything else that contains nicotine.


         It’s important to understand that every patient’s situation is unique. For this reason, this approach may require modification from time to time based on the patients particular needs. Under these circumstances it’s always important to consider the patients risk benefit ratio. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
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It is best to stop all nicotine containing products and cigarettes 4 weeks prior to elective cosmetic surgery.

Michael Hueneke, MD
Nashville Plastic Surgeon
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Nicotine and surgery



Its a hard question to answer with any level of certainty since there does not appear to be very good evidence to tell us that a certain time frame is ideal.  I would discuss this with each patient individually and let them know that the ideal would be to stop some reasonable time before surgery, perhaps a month or so but that smoking itself is likely much worse for healing.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 82 reviews

Nicorette and surgery


the negative effects of nicotine, which is spasm of the blood vessels and poor healing are the same whether the nicotine comes from a gum, a patch or a cigarette. The actual cigarette has some additional issues with your lungs and coughing, but the effects on the blood vessels is related to nicotine. I would suggest one month before and after all nicotine products.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.0 out of 5 stars 6 reviews

Surgery and nicotine replacement therapy


The answer to your question is surgeon-specific because there is not indisputable evidence to give an exact time when to stop nicotine replacement therapy.

Many surgeons would say no nicotine-containing products for 3 weeks before and none for 3 weeks after undergoing an elective cosmetic surgical procedure. Some would say longer amounts of time.

Ask you doctor what he/she recommends.

I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 32 reviews

Smoking & Surgery


I tell my patients no nicotine for 4-6 weeks before AND after surgery. It can delay the healing process. Congratulations on quitting smoking!

Michael A. Fiorillo, MD
New York Plastic Surgeon
4.5 out of 5 stars 16 reviews

Nicotine and surgery


Congratulations on quitting smoking.  Nicotine, in any form, can increase healing problems related to surgery, as it can compromise skin circulation.  This is particularly true for tummy tucks and facelifts.  You should therefore be off all nicotine products, including Nicorette, for at least 4 weeks prior to, and after surgery.

Arnold S. Breitbart, MD, FACS
Long Island Plastic Surgeon
5.0 out of 5 stars 44 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.