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 16

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
5.0 out of 5 stars 48 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

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
5.0 out of 5 stars 55 reviews


I would recommend stopping at least 4-6 weeks prior to elective surgery to allow time for vascular recovery and decrease the risk of healing problems or tissue loss.  Good luck.  Donald R. Nunn MD  Atlanta Plastic Surgeon

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 15 reviews

How long before surgery should I stop nicotine replacement therapy?

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 mommy makeover where the viability of the skin/tissue, belly button, and 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 and at least 6 weeks after any surgical procedure. The longer, the better. Nicotine always increases the risk for infection, nipple necrosis, poor scarring, and wound complications, as well as other health consequences including blood clots. The anesthesia risk is greater with general anesthesia as well as pulmonary issues/lung infections postoperatively. 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

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 91 reviews

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. 


It is best to stop all nicotine containing products and cigarettes 4 weeks prior to elective cosmetic surgery.

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 124 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
4.5 out of 5 stars 11 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.