How Long Do I Need to Be off Smoking After Breast Implant Surgery?

I had breast augmentation 24 days ago and I know smoking is VERY important to the healing. I quit 3 weeks prior to sugery, a week before the "quit date" that I cut down to only 1 per day. I started smoking again at 3 weeks after my surgery. Now, I am just wondering if this will have an effect on my healing? My incisions look like they are coming along very well, but I still have have stitches, they are the dissolving kind. What is your opinion? Thank you very much for your help!!

Doctor Answers 14

How Long Do I Need to Be off Smoking After Breast Implant Surgery?

In my practice I recommend that my patients quit smoking at least 2 weeks before and after surgery. If you waited 3 weeks after surgery to resume smoking you should not have issues with delayed healing, however continue to assess your incisions and make sure that they are completely healed with no sign of infection. Stay in touch with your plastic surgery if you notice any delay in the healing process. 

Houston Plastic Surgeon
4.5 out of 5 stars 24 reviews

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Smoking is Bad Before and After Surgery

Most experts unanimously agree that smoking increases the rate of  breast augmentation surgical complications significantly - This applies both before and after your surgery. For example smoking after surgery dramatically increases your risk of having a capsular contracture (hard abnormal looking breasts).. Just about all plastic surgeons strongly recommend  women  to stop smoking and all nicotine products well in advance of breast augmentation with breast implants and not to start afterwards.  Many plastic surgeons recommend stopping all tobacco products several months prior to surgery.A scientific article in the Archives of Internal Medicine indicated that, among all forms of surgery, quitting smoking eight weeks prior was never associated with an increased risk of complications.

Here is the reason why: the nicotine in cigarettes and other tobacco products (including Nicorette gum, patches, etc) is a vasoconstrictor, meaning it makes the Smoking is a significant multiplier of many potential complications following surgery and breast augmentation with implants are no exception. Nicotine from smoking causes blood vessels to vasoconstrict ( tighten up). Over time, these constricted arteries and capillaries deliver less blood to the breast tissue which is needed for normal healing. Smokers therefore have an increased incidence of higher likelihood of complications such as infection, and in particular capsular contracture (hardening and distortion of the implants). General complications of surgery such as blood clots, anesthetic problems such as pneumonia are also increased. For a tummy tuck there is increased likelihood of both an infection and loss of skin because of inadequate circulation.

In young patients you will probably statistically avoid these complications, why tempt fate by increasing your odds that something bad will happen. .On a long term basis, smoking also causes accelerated aging of the skin and loss of elasticity. Hopefully these reasons will help give you the will power and courage to stop smoking.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 59 reviews

Better to stop for the entire length of your recovery

It is a good idea to stay away from cigarettes for at least 2 weeks after surgery, although it is better to stop for longer if possible to facilitate your recovery because you are at a higher risk of experiencing skin loss and poor wound healing.

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.
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 29 reviews

How long do I need to be off smoking after breast implant surgery?

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 breast augmentation where the viability of the nipple-areolar complex is obviously important. Since the vascularity to the area is already tenuous with placement of the implant beneath, 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, and wound complications, as well as other health consequences. The most devastating consequence of infection, especially since an implantable prosthetic device is used, is increased. This along with wound healing and scarring. 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 13 reviews

Smoking and Surgery

Thank you for the question.

The use of nicotine (as in any form)  can lead to devastating complications after surgical procedures. Nicotine is a potent constrictor of blood vessels, preventing the delivery of oxygen etc. to surgical sites  that require good  blood flow to heal. The resulting decreased blood flow leads to potential problems with healing, tissue necrosis, open wounds,  infections…

Don't even think about the use of nicotine around the time of your surgery.n  Ideally, you don't smoke after surgery either.

Best wishes

Smoking and implants

In general, smoking should not be done.  But, I usually ahve patients do what you did and avoid 3 weeks before and stay off 3-4 weeks after.  But even still there are increased risks.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Breast augmentation and smoking

Smoking and diabetes account for a large majority of wound healing issues.  If you add bad nutritional habits and general lack of physical conditioning to that the wound healing problems become more commonplace.  Stop smoking and give you incisions time to heal.

Smoking and Plastic Surgery

Do not go hand in hand. You are basically guaranteeing yourself to have issue with your health and/or your plastic surgery.

It is a fact that patients who smoke have a higher capsular contracture rate.

So eventhough you may have healed well, you are setting yourself up for problems with your surgery as well as your health.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 49 reviews

Smoking and Healing

No disease or man made disaster has claimed more lives and caused more diseases than smoking which affects nearly every organ system in the body. While smoking enriches and keeps busy every medical specialty and morticians as well, it has hampered and frustrated Plastic surgeons since they came into existence.

Nicotine and the hundreds of other toxins found in smoke reduce the amount of oxygenated blood flowing through the skin. Any reduction in oxygen supply to the skin affects the texture of the skin long term but severely impacts healing in the short term. The question you should be asking yourself is NOT when can I start poisoning myself again - safely (ridiculous question - you must agree)? But instead : When can I start choking and reducing the amount of oxygen flowing to my healing skin (and brain, and heart, and kidneys...)?

Post surgical healing goes on for up to 8 months. You decide.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 69 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.