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 (24)

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 45 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 16 reviews

Smoking Before 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…

Try to be nicotine free prior to surgery and stay nicotine free after surgery as well.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 727 reviews

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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 8 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 27 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 12 reviews

Breast augmentation and smoking

In my practice I recommend to my patients to quit smoking for at least 2 weeks prior to and after surgery. Nicotine constricts the blood vessels resulting in poor tissue perfusion and oxygenation. This can considerably delay the healing process. If you are contemplating plastic surgery, you may also want to seriously consider quitting smoking altogether. Surgery always entails some level of risk and smoking greatly increases those risks.

Michael E. Ciaravino, MD
Houston Plastic Surgeon
4.5 out of 5 stars 11 reviews

Smoking has a detrimental effect on recovery following breast augmentation

Smoking is very detrimental to the recovery process following breast augmentation and other surgery. It compromises your immune system making your body less effective in fighting infection. It also hinders circulation making the recovery process slower. I usually recommend my patients stop smoking about two weeks before surgery. 

You may still be able to get breast augmentation. Please ask your surgeon for their advice. 

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 59 reviews

Smoking and breast implants

Smoking (even a single drag) limits blood flow and oxygen to the surgical wound - which means you don't heal as easily or as well. I ask that my patients stop smoking at least two weeks before and two weeks after surgery - once you've stopped for four weeks why go back? Kick the habit - you'll look younger, have a better result, your scars will be less visible, and be healthier. Good luck.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 67 reviews

Smoking Increases Complications in Surgical Patients


         It’s not unusual for cosmetic surgery patients to smoke a cigarette. When patients smoke cigarettes, they have an increased rate of complications. This occurs for several reasons; including constriction of blood vessels and decreased oxygen carrying capacity of red blood cells. This can result in decreased blood flow and decreased oxygen delivery to the skin and subcutaneous tissue.

         Patients who smoke cigarettes have a higher incidence of wound breakdowns, open wounds, tissue necrosis, infection and scarring. For these reasons, surgeons are very cautious when treating patients who smoke cigarettes or use nicotine products.

         The risk varies with the type of procedure performed. Procedures that involve extensive undermining of skin such as facelifts, abdominoplasty and breast reduction are associated with high complication rates. In cigarette smokers, procedures like rhinoplasty and breast augmentation that have less aggressive dissection are less likely to have wound complications.

         In an effort to minimize complications associated with cigarette smoking, we recommend not smoking for four to six weeks prior to surgery. We also recommend not smoking for at least one month following surgery. This approach is modified based on the type of procedure performed.

         Although the complication rate from cigarette smoking in breast augmentation isn’t high compared to some types of surgery, it still can be significant. For this reason, breast augmentation patients should stop smoking before undergoing surgery. Also, patients who stop smoking prior to surgery, have a decreased incidence of pulmonary complications. If you have questions regarding cigarette smoking and your surgery, make sure you discuss them with your surgeon.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 78 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.