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Does Smoking Slow Down the Healing Process in Breast Reduction Surgery?

Does Smoking Slow Down the Healing Process in Breast Reduction Surgery?

Doctor Answers (14)

Smoking and Breast Reduction Surgery

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Yes, smoking will affect the healing process after breast reduction surgery. I require that all of my surgical patients stop smoking at least one month before surgery. Ideally, they should not start smoking again at all but especially not sooner than 4 weeks after surgery. Smoking, among other things, impedes the ability of the blood to carry oxygen to the body tissues. Without oxygen the tissues cannot repair themselves at the rate they normally do which can lead to increased recovery time, more apparent scarring and other adverse complications. Be sure to advise your surgeon about your smoking habit and follow his or her advice on smoking restrictions.


Toronto Plastic Surgeon
4.5 out of 5 stars 46 reviews

Smoking and surgery

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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. 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.
Best wishes,
Pablo Prichard, MD

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

Does smoking slow down the healing process in breast reduction surgery?

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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 procedures as breast procedures and a tummy tuck where the viability of the nipple, belly button, and skin flaps are obviously important. Since the vascularity to the area is already tenuous with the dissection of the abdominal tissue as well as cutting around the areas, 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, skin flap necrosis, and wound complications, as well as other health consequences. There is an increase pulmonary risk with the anesthesia and postop lung infections. The most devastating consequence of infection, especially since the tissue is tightened, is increased. This along with wound healing and scarring. Some surgeons will refuse to operate on smokers and often check urine or blood levels prior. 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

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Does Smoking Slow Down the Healing Process in Breast Reduction Surgery

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Yes, absolutely. Smoking affects the blood flow to the tissue. Less blood supply means less healing. Most recommend at least 2 weeks before and 2 weeks after to quit smoking to maximize healing. The longer you have smoked the less effective quitting will be.

Kurtis Martin, MD
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Smoking and Breast Reduction Surgery: A Bad Combination

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In addition to its adverse effects on general health, smoking tobacco increases the chance’s of a plastic surgery patient having complications and can negatively affect her results and that includes Breast Reduction Surgery.

Dr. Nichter at the Pacific Center for Plastic Surgery would like to advise prospective patients of the dangers of smoking as they relate to plastic surgery.

A good plastic surgery result relies on good blood flow. The nicotine, carbon monoxide, and hydrogen cyanide in the blood of smokers inhibits their blood’s ability to deliver sufficient oxygen to their healing tissues. Thus, patients who smoke are at greater risk of complications and poor wound healing.

A long history of medical studies have shown revealed the risks patients take when they smoke. A 1984 study, which followed 1,100 face lift patients, “found that a smoker was 12.46 times more likely to suffer skin loss than a patient who did not smoke.”

A more recent study in 2003 reviewed 132 abdominoplasty patients. The study “showed wound healing problems in 47.9% of smokers versus 14.8% of non-smokers.”. These same risks would apply to Breast Surgery including Breast Reduction

Whether a plastic surgery candidate smokes or not is a big factor in whether a surgeon will perform surgery on that person or not. At the Pacific Center for Plastic Surgery, patients will be asked about their smoking habits, if any, which will be factored into the doctor’s decisions in her/his case.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
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Smoking can be disastrous in breast reduction surgery

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Absolutely!

 

Nicotine actually causes your blood vessels (arteries) to spasm. Arteries carry blood. Blood carries oxygen, antibodies, antibiotics, and all sorts of essential nutrients to help you heal. Deny your tissue of any of these...DISASTER!  A myriad of complications you don't want to even imagine!

Please stop smoking or don't have surgery. Simple as that.

Dr. H

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 127 reviews

Smoking and healing from surgery

+1

Yes, smoking interferes with healing from any surgery. In addition to stopping before surgery, it is important to stay stopped at least for several months post-op to allow healing (and, of course, it is best if you stay stopped!) I have had a couple of patients who looked fine for the first few days after surgery and then when they started smoking, the healing stopped and they lost some tissue that had been healing normally. Do yourself a favor and stop smoking. Good luck.

Margaret Skiles, MD
Sacramento Plastic Surgeon
3.5 out of 5 stars 10 reviews

Breast Reduction and Smoking?

+1

Ideally, you should be free of any type of nicotine product  for at least 4 to 6 weeks prior to breast reduction.  This holds true for other plastic surgical procedures that involve flaps such as facelifting and tummy tuck surgery.
Nicotine behaves as a vasoconstrictor of blood vessels thereby decreasing blood flow to tissues ( that need to receive blood flow to heal after surgery).  A decrease in this blood flow may result in wound healing problems and/or tissue death.
I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
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Smoking Causes Breast Reduction Healing Complications

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There is no question that smoking can interfere with breast reduction healing and may even cause significant complications such as loss of the nipple and skin segments. For this reason, one should quit at least two weeks before before this type of elective breast surgery. If one can't make that committment then the surgery should be delayed until one can do so or not have the surgery at all.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 27 reviews

Does Smoking Slow Down the Healing Process in Breast Reduction Surgery?

+1

Cigarette smoke contains substances that reduce the circulation of blood in the skin.

This can have very harmful effects on healing, especially for those procedures that involve the kinds of sculpting and tissue movement that plastic surgeons often do: facelifts, breast lifts and abdominoplasties. In breast reduction, for example, the risk of death of the nipple-areolar complex is much higher in smokers.

I ask my patients who smoke (thankfully there are fewer and fewer) to stop smoking for at least 3 months before surgery. They must must not consume nicotine (colleagues: spelling alert!) from any source during that time, including patches and gum.

Patients who stop smoking well before surgery reduce their risk of tissue death, but I caution them that their risk will always be elevated compared to the person who has never smoked.

Good luck!

Eric Pugash, MD
Vancouver Plastic Surgeon
5.0 out of 5 stars 53 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.