How Does Smoking Affect Breast Reduction Surgery? What if I Smoke One Cigarette a Day?

Doctor Answers (11)

Smoking: Don't Do It!


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.

Best wishes


San Diego Plastic Surgeon
5.0 out of 5 stars 681 reviews

Smokin and surgery


The short answer to your question is that smoking before and after surgery is bad for wound healing -- even one cigarette a day is bad.  The reason is that the nicotine in cigarettes impairs blood flow to the tissues.  Surgery will also stress the blood flow to the skin along the incisions.   The combination of both surgery and smoking will jeopardize the blood flow enough that you could have skin breakdown, skin loss, or even lose your nipple after a breast reduction surgery.  As others have already told you, please stop smoking in preparation for your surgery so that you can have the best outcome possible.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 8 reviews

Smoking Not Recomended for any type of surgical procedure


Dear May,

Smoking one cigarette a day can be disastrous! Please do yourself a favor and abstain completely until you are a few weeks post op. Not only does nicotine deprive the tissues from blood, it also carries (along with other nutrients involved in healing) antibiotics to help fight infection. So not worth the risk!

Kind regards,

Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 120 reviews

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Smoking is an unnecessary risk during breast reduction


Smoking will rob the healing tissue of the oxygen needed to heal and is a risk to any surgical procedure. You should quit altogether three to six weeks before your reduction.

Peter E. Johnson, MD
Chicago Plastic Surgeon
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No smoking after breast reduction surgery!


Tissues need oxygen from blood flow in order to survive. With a breast lift (mastopexy) or breast reduction, the tissues are rearranged in a way that reduces blood flow for a while. Nicotine from any source constricts blood vessels, further reducing blood flow. The combination of the surgery and nicotine can lead to tissue death (necrosis) even after one cigarette. It's an unnecessary risk.

Richard Baxter, MD
Seattle Plastic Surgeon
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Smoking Can Increase Complications After Breast Reduction


Dear May in Michigan.  It is laudable that you have reduced your cigarette use to one a day, but you still are increasing your risk of complications.  The nicotine in cigarettes impairs the blood flow in small blood vessels in the skin which can result in skin necrosis (death) and wound separation. Additionally, the nipple has an increased risk of necrosis because it may be on a long piece of breast tissue (breast pedicle) and is at the end of the blood vessels.  Any decrease in blood flow in the breast pedicle places the nipple at risk for necrosis.  

Additionally, the carbon monoxide in cigarettes inhibits the delivery of oxygen to the site of wound healing and further increases risks of delayed healing.  From an overall health standpoint, you will tolerate general anesthesia better if you have abstained from smoking, as well as decrease your risk of heart and lung disease.  Most surgeons recommend that you stop smoking 4-6 weeks before and after your surgery.  It can certainly be difficult to give up smoking so you may wish to talk to your primary care doctor about smoking cessation medications and support groups.  Good luck!

Matthew H. Steele, MD
Fort Worth Plastic Surgeon
5.0 out of 5 stars 36 reviews

Smoking and breast surgery


There are several ways to look at this question. Most plastic surgeons are going to have a policy about smoking, especially with breast surgery. There is no question that smoking even one cigarette will put you at a higher risk for complications with this procedure. And since it is a controllable variable, most plastic surgeons would advise you to stop completely before and for a period after breast reduction surgery. My policy is to stop 6 weeks before and for at least 2 weeks after surgery. That being said, I am sure there have been many patients of mine that have not followed the rules and have still had good outcomes. Some of your risk is going to be determined by the technique that your surgeon uses for the reduction as well. So the answer will always be to avoid smoking for any type of breast reduction surgery. It just doesn't make sense to increase your risk of problems. But if you were to cheat and smoke, you would most likely get away with it and not have any problems. That just wouldn't be my suggestion.

William T. Stoeckel, MD
Raleigh-Durham Plastic Surgeon
5.0 out of 5 stars 34 reviews

Smoking and breast reduction

I am glad that you are down to one cigarette a day. Smoking interferes with vascular circulation and inhibits wound healing. All smoking is therefore ill advised in plastic surgery patients but particularly in operations like the breast reduction in which circulation to the nipple is so important. Please try to quit at least 6-8 weeks prior to surgery.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

Smoking Definitely Affects Healing After Reduction


Smoking after a breast reduction can have very bad effects.  The problem is that a portion of the normal blood supply to the nipple-areolar area is interrupted.  A single cigarette post-op could cause the residual blood vessels to spasm resulting in a good deal of loss of tissue.

John Whitt, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Smoking and Breast Reduction


Dear May in Michigan,

Yes, even one cigarette is one too many.  There are many effects due to smoking that can impact your surgery and results.  Ignoring the pulmonary issues-which makes anesthesia more risky, the nicotine in the tobacco smoke significantly decreases the blood supply to the healing tissues and healing tissues need lots of blood supply to heal correctly.This is why a nicotine patch or gum is not a solution for surgery.

The carbon monoxide in tobacco smoke decreases the oxygen content that your red blood cells can carry so the blood that is getting there is less oxygen rich.  Oxygen is needed to heal. There are other chemicals in smoke that also have impact but these are the two biggies.

Studies also show that less than one cigarette a day is necessary to cause all of the bad effects of smoking on healing.  So, the recommendation is simple; stop smoking for at least 6 six weeks before your surgery.  This is one of the things you can do to help you have a successful surgery.  

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.0 out of 5 stars 18 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.