Effects of Smoking on Breast Augmentation Results?

What happens if you still smoke before Breast augmentation? What are the effects on the outcome of the breasts and can I ever smoke again? I've actually quitted in January and have maybe smoke 3 cigarettes since. I am hoping I could still get breast implants.

Doctor Answers 29

Smoking Effects on Breast Augmentation

Most experts unanimously agree that smoking increases the rate of  breast augmentation surgical complications significantly. Just about all plastic surgeons strongly recommend  women  to stop smoking and all nicotine products well in advance of breast augmentation with breast implants.  Many plastic surgeons recommend stopping all tobacco products several months prior to surgery.

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. 

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.

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.


Orange County Plastic Surgeon
5.0 out of 5 stars 76 reviews

Smoking affects healing

There is no question that smoking affects healing adversely. Smoking decreases the amount of oxygen in the blood by increasing the carbon monoxide in the bloodstream and by vasoconstriction. There are many more complications with those who smoke and have breast implants such as complications of anesthesia (pneumonia and collapsed lung), so it is a good idea to quit at least 2 weeks prior to surgery. I have also noticed in my practice that many more women get capsular contractures (breast implants that feel hard) when they have been smokers.

Smoking also breaks down collagen, and ages the skin and causes wrinkles much more than those who do not smoke. It makes yo look much older for your age.

Dan Mills, MD
Orange County Plastic Surgeon
4.5 out of 5 stars 22 reviews

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.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 37 reviews

Effects of smoking on breast augmentation results?

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 breast surgery 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 any surgical procedure. Nicotine always increases the risk for infection and wound complications, as well as other health consequences. This one cigarette will likely not impact vascularity, but 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

Smoking and breast augmentation

Thank you for your question. Smoking before or after your surgery can increase your risk of developing complications including infection and wound healing problems. I generally ask patients to stop a couple months ahead of surgery and then for a couple months after surgery.

Smoking and surgery

You need to follow your surgeons advice regarding ceasing smoking before and after your surgery. If you are not able to stop smoking it is best for you to be upfront with your surgeon and postpone your surgery until you are able to comply. The complications associated with smoking and surgery are not to be taken lightly.

Francis X. Fleming, MD
Kennewick Plastic Surgeon
5.0 out of 5 stars 4 reviews

Smoking Can Interfere with Your Recovery

The reason we recommend that patients quit smoking prior to (and after) surgery is that smoking can interfere with anesthetic and with your healing. It can affect your circulation which puts you at risk for various complications. We always want our patients to have the safest surgery and recovery possible so that they end up with a beautiful, safe, and natural looking result. Since we know smoking can impede that, we ask patients to quit for at least 2 weeks before and 2 weeks after. 

Smoking and Breast Augmentation

Certainly any physician will take any opportunity to encourage patients to stop smoking. The benefits to quitting are numerous indeed. With respect to surgery in particular the issues are airway and healing.

Smoking damages the airway and makes it more difficult to clear secretions which increases the risk of a pulmonary infection.

Nicotine constricts blood vessels which can delay wound healing. While there are some operations for which I insist that patients be free of nicotine for at least 30 days, breast augmentation is not one of them (breast lift and augmentation, on the other hand, is). I do not believe that the literature supports an increase risk of capsular contracture in patients who smoke, 

But still - I would encourage you to stop!

Smoking increases all of the risks

Smoking increases the risks of all surgeries.  The most significant long term risk associated with smoking and implants is capsular contracture.

Quitting smoking before a breast augmentation

I would be shirking my duty as a doctor if I didn’t suggest that now (before your breast augmentation) would be a good time for you to stop smoking. I also know how hard it is to quit and that some of my patients have sneaked a cigarette right before or after surgery. Here are the main concerns:

Anesthesia: Both nicotine and carbon dioxide can decrease your oxygen supply. The anesthesiologist needs to know about your smoking habits; he or she might express the possibility of some respiratory risks, such as an increased chance of bronchitis after surgery. Most of my patients are young and healthy and don’t have chronic obstructive lung disease, so it’s less of an issue.

Nicotine causes blood vessels to narrow, which slows down the flow of blood to the tissues and can affect the healing process. This is a concern when tissue flaps with thin skin are involved, such as in facelift surgery. It could cause a problem during a breast lift or breast reduction, but it has not been a problem for my patients during a breast augmentation.

Ted Eisenberg, DO
Philadelphia Plastic Surgeon
5.0 out of 5 stars 12 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.