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How Many Weeks Should I Be Smoke Free Before Tummy Tuck? (photo)

How Meny Weeks Smoke Free Shud I Be Before Tt One Told Me a Week Won't B Having Surgery There

Doctor Answers (8)

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. 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


Phoenix Plastic Surgeon
5.0 out of 5 stars 29 reviews

How many weeks should I be smoke free before tummy tuck?

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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 a procedure as a breast augmentation where the viability of the skin/tissue, and 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 and at least 6 weeks after any surgical procedure. The longer, the better. Nicotine always increases the risk for infection, nipple necrosis, poor scarring, and wound complications, as well as other health consequences including blood clots. The anesthesia risk is greater with general anesthesia as well as pulmonary issues/lung infections postoperatively. 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

How Many Weeks Should I Be Smoke Free Before Tummy Tuck?

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The problem with smoking and lift surgery (face lift, breast lift and reduction, tummy tuck) is that nicotine diminshes blood flow.

The surgery itself involves separating the skin from much of its blood supply by dividing the small arteries from the muscles under the lifted tissue. Nicotine causes small blood vessels to narrow, further reducing blood flow sometime to a level resulting in tissue death. 

The real danger time is after surgery, and probably for about 6 weeks. Most surgeons have seen awful wound problems in patients who resumed smoking shortly after surgery. If you can't quit for a week before surgery, how will you be able to quit for six weeks after? Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 34 reviews

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How Long Must I Quit Smoking Before TT

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Every surgeon has their own preference, but I recommend quitting all nicotine products 6-8 weeks prior to your surgery and at least 1 month post-op or simply quitting all together after that.  Smoking can negatively effect wound healing so in order to achieve optimal results, it's very important that you quit.  

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Smoke Free with Tummy Tuck

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I recommend a minimum of 2 weeks with no nicotine, not just smoking.  Nicotine gum, patches, or any other type of nicotine replacement causes the same risks as the nicotine in tobacco smoke.  You do need to avoid second hand smoke as well.  Post surgery, I require a minimum of 3 weeks and Dr. approval before nicotine use.

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How Many Weeks Should I Be Smoke Free Before Tummy Tuck?

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Most plastic surgeons will recommend a month before surgery and for 6 weeks after surgery.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
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Nicotine free

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I advise my patients to be nicotine free (not just smoking- but all nicotine products) for 6 weeks prior to surgery, as well as the first few weeks into recovery.  Nicotine can adversely affect wound healing and rates of infection.  Good luck.

Mennen T. Gallas, MD
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Smoking and tummy tucks

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Every surgeon has their own level of comfort with smokers so be sure to ask your doctor their preference.  I tell my patients to be off all nicotine products (including the patch, nicotine gum, second-hand smoke, etc) for at least 4 weeks before and after surgery.

Victor Ferrari, MD, FACS
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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.