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Will Smoking Cigarettes Slow the Healing Process?

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Cigarettes and Breast Lift


   I would not perform a full breast lift on a smoker.  The patient should have abstained from smoking for at least 1 week prior to surgery.  If the patient is a pack a day smoker, smoking should be stopped for a month prior to surgery.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 230 reviews

Stop Smoking Before Surgery!!!


The nicotine in tobacco is a vasoconstrictor, meaning that it causes blood vessels to clamp down. This results in decreased blood flow, and decreased oxygen supply, to healing skin and other tissues. This will always have a negative effect on healing, and can be catastrophic for some procedures like breast lifts, breast reductions, facelifts or tummy tucks. Skin can die without sufficient blood flow and oxygen, as can the nipple and areola. It is best if you can stop smoking completely for at least 4 weeks before surgery, and for a few weeks after surgery until you are clearly healing well. Certain devices to stop smoking contain nicotine, so they are also a problem.

Andres Taleisnik, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 15 reviews

Smoking and the healing process

Your Breathing 
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.

Your Heart

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.

If patients do not stop smoking for at least 4 weeks before surgery, their surgery may be rescheduled.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 70 reviews

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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. 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.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 28 reviews

Will smoking cigarettes slow the healing process?

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 mastopexy where the viability of the 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 12 reviews

Smoking and a breast lift


Smoking increases the risk of surgical post-op complications.  I usually  recommend to stop 3-4 weeks before surgery and to stay off cigarettes for 3-4 weeks after as well.  Good luck.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Smoking and Breast 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…

I would suggest that you stop prior to surgery and try not to start again afterwards.
Best Wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 reviews

Will Smoking Cigarettes Slow the Healing Process?


Smoking cigarettes will not only slow the healing process,but  will cause wound breakdown and even tissue loss especially in cases of breast surgery,and facelift surgery

Even second hand smoke has a deletereous effect

It is therefore most important to quit smoking before surgery ,the longer the better.You should also supplement with antioxidants such as raw fruit and vegetables

Hilton Becker, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 6 reviews

Smoking and surgery


Yes, smoking impairs wound healing of both the skin and bone.  I generally advise patients to stop smoking for at least 3 weeks prior to surgery and 3 weeks after surgery.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.0 out of 5 stars 5 reviews

Plastic Surgery and Smoking



Yes, smoking absolutely increases the risk of poor healing and other complications after surgery for many reasons:

  • It robs the skin of oxygen and causes poor healing.
  • It increases the risk of infection in your lungs after anesthesia.
  • It increases the risk of scabs and crusts in your incision.
  • It increases the risk of blood clots in the legs which can be deadly.

Smoking is especially dangerous with tummy tucks, facelifts,breast reductions, and breast lifts.

You can lessen (but not eliminate) the risks by stopping smoking at least 6 to 12 weeks before your surgery.

Good luck and thanks for a very important question.



Stephen M. Lazarus, MD
Knoxville Plastic Surgeon
4.5 out of 5 stars 3 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.