It is 7/2 and I Have Abdominoplasty Scheduled 8/16, I Am a Smoker and 24 Years Old. Risks?

It is July 27, 2012 and I have a scheduled abdominoplasty with liposuction scheduled for August 16, 2012, the only date I am able to have surgery because of being available to take care of my toddler. I am 25 years old and have been smoking for about a year now, up to one pack per day. I have been smoking today and am afraid of risks associated with this when it comes to healing? I also recently was tested for an STD after 1 partner and found out that I has HSV2, should I notify the doctor?

Doctor Answers 9

Absominoplasty scheduled, when to quit

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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 patients 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 about all tests. 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.

Quit Smoking---now.

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Regardless of the surgery planned, smoking increases the risk of complications significantly-this has been studied in plastic surgery as well as other surgical specialties. If you are concerned about accommodating your schedule, you will likely have a complication with healing that will take much longer to recover from than scheduling your surgery in the future.

William Loutfy, MD
Albuquerque Plastic Surgeon

Dangerous situation

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It is recommended that you cease smoking for at least 6 weeks prior to your surgery and continue with the smoking cessation through your recovery period.  If you do not, you may suffer poor healing in the form of infections, tissue loss, and wounds that won't heal.  As far as the STD portion of your question, yes you should notify your plastic surgeon.  He/she needs to be fully aware of your medical history in order to most safely care for you during your procedure.

Mennen T. Gallas, MD
Katy Plastic Surgeon

You must not be too worried if you continue to smoke while knowing it's BAD!

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Of course, we all know smoking is bad (for lots of reasons); but for someone scheduled for elective surgery in 2 weeks, this is similar to letting your toddler play with a loaded gun and "worrying about it" and asking if you should do something about it!

You already know the answer.

None of us is going to give you absolution for doing something we ALL know has very real and very BAD potential problems. Perhaps not in every case, but 15-20% of cases is too high a potential risk to proceed with elective surgery. Dead skin and open wounds, and horrible scars, and re-operation (not to mention costs and more time off), are not insignificant issues to be "wondering" about!

Reschedule surgery; please do your surgeon the favor of letting him/her know ASAP so your surgical slot does not go "wasted." There are more people than your surgeon and you geared up for your elective surgery, and cancellation costs are real also.

Stop smoking, not only so you can have your elective surgery with the lowest risk possible, but also because of the health benefits to your toddler, yourself, and anyone else in your household. (You will also pay for the surgery with reclaimed cigarette costs--what is a pack of cigarettes now? About $5 per day adds up over time.) Best wishes! Dr. Tholen

Dangerous to smoke before any cosmetic procedure!!!

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Hi and thanks for your question.


As all the previous surgeons have stated, smoking is strong risk factor for a terrible result for any cosmetic procedure, particularly tummy tucks, breast augmentation, and face lifts. Before you spend your money, please quit smoking for at least 6 weeks before the procedure. Otherwise, you are literally throwing your hard-earned money away. 


Take care!

Implications of smoking for tummy tuck

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FIrst, it is extremely important for you to disclose all medical history, including HSV2, to your plastic surgeon. Secondly, smoking is extremely injurious to wound healing and greatly reduces circulation to the area. You should be afraid of the risks and, frankly, I would not operated on you under the circumstances you have described.

Smoking And Abdominoplasty Do Not Go Together At All

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I will not perform a standard tummy tuck in a patient who smokes.  The risk of large areas of tissue necrosis is simply much too great.  A single cigarette can be troublesome.  You should delay your surgery until you are able to cease smoking.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Smoking is a major cause of "disaster" with cosmetic surgery

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Everyone knows that smoking is bad for them. People often do not realize how bad it actually is when trying to heal from surgery. There are many physiologic reasons why this occurs and I would agree with Dr. Gottlieb's excellent answer about why this happens.

In a nutshell, smoking causes healing problems. In a tummy tuck with a foot long (or longer) incision there is a large area that needs to heal. The blood supply is altered during surgery in order to tighten and remove tissue and smoking is enough to make this entire incision not heal. You could be left with a wound that takes weeks or months to heal. Even if you get lucky and heal, you often will have a worse scar.

My advise: Stop smoking today! Do not take the risk. Many plastic surgeons will cancel your surgery if they know you are smoking. I do not knowingly perform abdominoplasty on smokers.

Don't bother with the nicotine patch or gum as the nicotine is still getting into your system. Perhaps the electronic cigarettes might help or a medication might help from your family doctor. I also attached below a blog post I had written on this topic some months ago...

I tell all patients to stop smoking for at least 2 weeks prior to surgery and for 2 weeks afterwords. Some surgeons think you need to stop even longer. At this point your surgery is less than 3 weeks from now. So, stop now!

Good luck!

-Evan Sorokin

I Have Abdominoplasty Scheduled 8/16, I Am a Smoker

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You are taking a real and unnecessary risk by having a tummy tuck while smoking.

When that procedure is done, the skin and fat are lifted away from the abdominal muscles, and when doing that a large portion of the blood supply to the abdominal skin and fat is gone. In most patients, there is still plenty of blood supply to allow that tissue to survive.

But in a smoker, there is an additional cause for decreased blood supply. The nicotine causes constriction of blood vessels, and this addition insult to the flow of oxygen and nutrients to the tissues often results in a situation where the wound edges don't heal and the skin at the bottom of the incision dies. Either of these leads to a prolongued post-op course, and can lead to additional surgery. 

This added risk is not present for all surgeries, but is true for all "lifts"--tummy tuck, face lift, breast life and reduction. 

Stopping smoking is the only way to avoid these added risks. Nicotine products, such as patches or gum are actually as bad or worse than smoking in terms of blood flow to the skin.

You have good reason to be afraid of the risks of smoking and healing. They are real, and they are not statistical rarities--they are common, and plastic surgeons have all seen them. 

Consider rescheduling after you have been able to quit smoking. Thanks for the question, best wishes.


Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.