I have smoked on and off since I was 15. Never smoked a pack a day, maybe just one or two cigarettes. About a couple of years ago I started to smoke black and milds (cigar) about once a day or every other day. I am supposed to have a tummy tuck with liposuction in my flanks in about a month. I stopped two weeks ago. What are my chances of complications?
Chances of Complications from Smoking a Month Before Tummy Tuck and Lipo?
Doctor Answers 18
Smoking a month before tummy tuck and liposuction. Complications?
Congratulations on quitting. 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.
Smoking and plastic surgery risks.
I congratulate you for quiting smoking. Keep it up. It is probably the single best thing you can do for your health. Most studies have shown that stopping smoking for a minimum of one month is the best method to reduce your risks. This places you in the risk categroy of an "ex-smoker" but not necessarily a "non-smoker". Ex-smokers have approximately a 50 times higher risk of complications when compared to non-smokers. It takes about 10-15 years to go from an ex-smoker to a non-smoker.
Smoking and 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.
Pablo Prichard, MD
You might also like...
Chances of complications from smoking a month before tummy tuck and lipo?
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. I would discuss this with your surgeon prior to your procedure. Hope that this helps! Best wishes!
A tummy tuck can be done as a solitary procedure. Many times the results are enhanced by adding liposuction to the hip and love handle area. A tummy tuck is also done in combination with a breast augmentation in a mommy makeover.
Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!
Smoking and Tummy Tuck Surgery: Bad Combination
Completely stopping smoking AND all nicotine products before hand makes a big difference. Six weeks is good but studies show that 8 weeks is even better. Here is why:
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.
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 recent study in 2003 reviewed 132 abdominoplasty (Tummy Tuck) patients. The study “showed wound healing problems in 47.9% of smokers versus 14.8% of non-smokers.”
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.
Smoking and tummy tuck.
It sounds like you will have not smoked for about 6 weeks by the time of your tummy tuck. I think this is safe.
Smoking and tummy tuck
As the data accumulates you should be tobacco free for at least 4 weeks before and very importantly, 4 weeks after. I have my patients stop for 3 months. I have found that if you can be tobacco less for 3 months you are much less likely to start up again when you are starting to feel better after the surgery.
I can very often tell by the way a wound is healing, when the patient starts smoking again.
Smoking and Risks of Complications in Cosmetic Surgery
You were correct to stop smoking a few weeks ago if your surgery is in a month. Studies have shown that the complication rates are significantly higher for patients who smoke 4 weeks before and 4 weeks after surgery. The nicotine is the problem. Nicotine causes constriction of blood vessels so the amount of blood getting to the skin edges of the wound after surgery can be severely effected by smoking and nicotine. The bad news is that nicotine patches and gums are not a good alternative to smoking because they have the nicotine in them as well. So you are best off to avoid all cigarettes, cigars, nicotine gums and patches for the month preceding and following your surgery. The complications can be severe in a tummy tuck with skin flap wound healing issues like breakdown of the incision to loss of the skin of the abdomen or belly button. It is not worth the risk!
Chances of complication from smoking before Liposuction and Tummy Tuck
Much, much lower, but never zero.
We THINK that some of the poorer blood supply complications are caused by blood vessels spasms/constriction. No scientific paper has yet proven definitively when you are TOTALLY safe. So - what to do? How long can you last without Nicotine? The longer the better.
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.