I am scheduled for a breast lift on May 21. When I went to the doctor in March he told me I needed to be cigarette-free for 4 weeks before surgery. So, about 5 weeks ago I went from about 14-15 cigarettes a day to about 1 per day. This past week I went from 1 to nothing. Should I be ok for surgery in 1.5 weeks?
Smoking Before Breast Lift?
Doctor Answers (11)
Talk to your surgeon, especially about the pain you're feeling
The problems associated with smoking:
Smokers are more likely to experience breathing problems following surgery than non-smokers (40% compared to 11%) because tobacco smoke damages the lining of the lungs. When the lungs are compromised, they are less efficient in clearing away waste (secretions and particles). This, coupled with the decreased efficacy of a smoker's immune system, can lead to post-operative infections and/or pneumonia.
The nicotine in cigarettes affects nervous systems, leading to faster heart rates (heart stress) and high blood pressure. Combined with the carbon monoxide present in tobacco smoke, a substance that reduces the body's ability to transport oxygen to the heart, smokers become much more susceptible to heart attacks (at a rate of 80% higher than non-smokers). Heart stress is also much more commonly witnessed by anaesthesiologists.
A smoker's compromised immune system leads to a rate of post-operative wound infection that is six times higher than non-smokers.
Fortunately, patients who stop smoking before surgery are able to protect themselves from many of the complications that can occur during their procedure. Taking this precaution reduces surgical risks and may help create a more successful treatment outcome.
Cigarette smoke contains carbon monoxide that reduces the ability of the red blood cells in a smoker's body from transporting oxygen throughout the body. The presence of carbon monoxide in the blood is reduced by half when no cigarettes are smoked for four hours and, better yet, is reduced to a safe level if cigarettes are avoided for eight hours. Stopping smoking before and after surgery helps oxygen to more effectively travel throughout the body, an essential tool in warding off infection and successful wound healing.
Smoking and 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. This is especially bad in breast reductions or face lifts. Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion. Vaporizers do not decrease the amount of nicotine in tobacco, only decrease the smoke.
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.
Pablo Prichard, MD
Smoking before breast lift?
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!
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You will need to inform your plastic surgeon of your situation. Only he will be able to make the decision whether or not to proceed with surgery. Otherwise, you will receive a variety of online opinions; none of them may be specific/relevant given that every plastic surgeon may have a different practice.
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.