Tummy Tuck Recovery and Necrosis Risk Due to Smoking?

First of all even a social or "occasional smoker" is still a smoker and this brings real risks to your surgery. Discuss your risk factors such as your smoking history candidly with your plastic surgeon and ask for his advice and recommendations.

Most experts unanimously agree that smoking increases the risk of most surgical complications significantly. This especially applies to all  lifting such as a tummy tuck procedure that you are scheduled to have done. Just about all plastic surgeons strongly recommend women to stop smoking and all nicotine products well in advance of all plastic surgery and especially lift procedures..  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 constrict ( spasm or  tighten up). Over time, these constricted arteries and capillaries deliver less blood to the tissue which is needed for normal healing. Smokers therefore have an increased incidence of higher likelihood of complications such as tissue sloughing (death by necrosis) and infection.  General complications of surgery such as blood clots (deep venous thrombosis) which can travel to your lungs (pulmonary embolus), anesthetic problems such as pneumonia are also increased.
A recent 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

Smoking brings a significant risk of cancer, stroke, heat attack, etc. From a Plastic Surgery standpoint it is a vasoconstrictor. Wound healing is all about getting oxygen and needed entities to the wound. It is well known that patient who smoke have a tremendous increase in their rate of serious complications, (infections, wounds falling apart, etc.). Nicotine is the main vasoconstrictor, so getting a patch or lozenge of nicotine won't help the vasoconstriction. Best to be off the tobacco/nicotine entirely before surgery. Please be honest with your Board Certified Plastic Surgeon. Together you can make a plan to quit and proceed with surgery. The amount of time between quitting and surgery will depend on the Plastic Surgeon and the procedure.

Each surgeon has his or her own instructions regarding smoking before an dominant plasty. It is very important to respect and follow those recommendations closely. Each surgeon also has his or her own postoperative directions to be followed after a tummy tuck (abdominoplasty). There are however some generally accepted guidelines that most surgeons agree on. In the performance of a full abdominoplasty the skin and fat layer has been elevated off of the underlying muscle layer. This creates two large surface areas that have to heal and seal the space between the two layers. As long as the space remains open and the raw surfaces remain, drainage will continue. Drainage stops when the two surfaces have completely healed and no space remains tween the two layers. This normally takes between ten and fourteen days to occur. During this two week period if there is too much activity these two surface areas continued to shift back and forth over each other preventing adherence and delaying the healing process. For that reason it is best to plan on remaining home for two weeks and keeping activity to a minimal level to allow for the greatest chance of healing and the cessation of drainage. It is important to keep the wounds clean to prevent infection. Patient's should not sleep with their pets. This will help prevent infection. If the muscle has been tightened it is important not to engage in strenuous core activities for at least eight weeks. Aggressive abdominal exercises should not be performed for twelve weeks. Resolution of swelling is different from patient to patient. Most often the swelling is gone and the final result is realized within 6 -8months. A well performed abdominoplasty can be a truly life changing experience. For patients to have the best chance for a good outcome and is very important to strictly follow the postoperative directions of their surgeon.