I Am Having Surgery for Ventral Hernia Repair and an Abdominalplasty Done in About 2 Weeks but I Smoked a Cigarette?

Cigarettes increase your risk of complications.  I have all of my patients stop one month before surgery.  In most circumstances you will be ok but if you have a problem you will regret the cigarettes.  Remember that most people do not die of smoking but rather get chronic diseases such as emphysema and atherosclerosis which disrupt your ability to carry out simple daily activities. 

If you are a smoker, you have an increased risk of wound healing complications following tummy yuck, especially the risk of skin slough.  If you had a cigarette or two several weeks prior to your surgery it probably will not make any difference.  However, I am concerned that telling you that will make you think that another won't hurt, then another, and so on and so on.  So,try not to have any more cigarettes. It's really important.

Dear Cali,One cigarette a few weeks before surgery is not the end of the world if you are not a smoker.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. In a rhinoplasty the tip of the nose and the columella, the area between the tip and the lip, is at risk. Your skin and tissue can turn black and fall off if this happens. 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. Hookah also does not decrease nicotine.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

It sounds as if you have smoked minimally over the last few weeks which is good.  However, any smoking can delay wound healing.  I would also let your surgeon know so he or she can decide if you should postpone surgery.  I would also stop smoking completely (both now and after surgery) as this is the best gift you can give yourself.  Good luck to you!

Let your surgeon know and decide, and don't smoke anymore unless you want to cancel. And especially, don't smoke after surgery.  All the operations we do involving lifts (such as face lift, breast lift or reduction, tummy tuck) involve separating the skin from the underlying structures and markedly diminishing the blood flow to that skin. Nicotine causes still more loss of blood flow to the skin by narrowing the small blood vessels. This double insult often results in inadequate blood supply, risking  tissue loss and delayed healing, which can leave open wounds for months. 

Don't think about nicotine gum or patches--they are as bad or worse than cigarettes in this regard. 

 

Your call. Best wishes.

You need to let your surgeon know and discuss with him or her if the smoking that you have done will increase the risks of complications unacceptably. Smokers are at higher risk for complications and the more you smoke the higher the risk. And the longer between the last cigarette and the surgery the better. Your surgeon knows your individual situation best as well as the planned surgery and is in the best position to decide whether the risks outweigh the benefits. Good luck to you and please do yourself a favor and stop smoking.