Will I Have Necrosis if I Stop Smoking 1 Month Prior to a Tummy Tuck?

Doctor Answers 11

Will I have necrosis if I stop smoking 1 month prior to a tummy tuck?

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 tummy tuck where the viability of the skin and belly button 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!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 17 reviews

Smoking and Tummy Tuck Surgery?

Thank you for the question.

You should be free of any type of nicotine product  for at least 4 to 6 weeks prior to tummy tuck surgery.  This holds true for other plastic surgical procedures that involve flaps,  such as facelifting and breast lifting surgery.

Nicotine behaves as a vasoconstrictor of blood vessels thereby decreasing blood flow to tissues ( that need to receive blood flow to heal after surgery).  A decrease in this blood flow may result in wound healing problems and/or tissue death.

I hope this helps

Smoking risks with tummy tuck

Thanks for your question -

As you've read from the other surgeons, smoking is a serious risks for complications. In addition to umbilical or superior abdominal flap necrosis, you also risk anesthesia complications including pneumonia.

Usually a month is enough time to begin to minimize your risk. Remember, this doesn't only mean stopping smoking but avoiding nicotine gum, the patch or other sources of nicotine which can contribute to problems.

Also, be sure to have a plan for avoiding smoking during your recovery period. Many times patients can be at greater risk for relapse because you have increased downtime while your recovering and boredom or anxiety can contribute to the desire to smoke.

I hope this helps!

Smoking does increase tummy tuck risks

Smoking is known to increase the risks of poor healing in a tummy tuck procedure. The complications seen are often separation of the wound edges, though can be as severe as spotty areas in the lower abdomen where the skin and tissue dies because of the decrease in the oxygen reaching the skin. Complications, such as these, are very rare in non-smokers. The same such risks apply to patients seeking facelift, as well. Complete cessation of smoking one month before, and continued hopeful indefinitely after, will significantly reduce risk. You cannot use nicotine patches in place of smoking. The longer you go smoke free, the better your odds of a safe and satisfactory result.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 38 reviews

Smoking and tummy tucks

Dear Puddin0

No one can guarantee you will not have skin slough if you don't smoke, but you will greatly increase your chances of an assortment of complications if you do smoke so the longer you are off cigarettes the greater the chance of a better result with fewer complications.

Discuss this with your plastic surgeon and good luck on your surgery.

Steven Schuster MD FACS

Smoking & Tummy Tuck

Anyone undergoing a TT has some risk of necrosis. Smoking definitely increases the chance for necrosis. In fact, I will not perform a TT on an active smoker. I think that if you do not smoke for 1 month prior to surgery, you will significantly decrease the chances of necrosis, but again that risk can never be entirely removed.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Smoking and the risk of skin necrosis

Any procedure that undermines the skin to obtain the result (tummy tuck, breast lift, and fecelift) carry the risk of skin death and delayed healing. Smoking increases this risk becasue the nicotine constricts blood flow. It is the nicotine, not the smoke, that is the problem so gums, pathes and second hand smoke are also bad. By stopping for a month at least you have taken your risk down but it is never zero.

Smoking, necrosis and tummy tuck

First, anyone can get some necrosis with a tummy tuck procedrue. The risks increase under certain conditions like smoking. The smoking decreases the blood flow and that is what is needed for good healing and keeping the skin and fat alive.

One month should be sufficient to help minimize the risks of necrosis BUT, you need to stay smokeless(incliuding second hand smoke) for one month after tyhe surgery also. That is the most critical time.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 27 reviews

Smoking and Tummy Tuck

Smoking increases the risks of decreased blood flow to the the skin in any surgery that involves raising, pulling, and tucking. Stopping smoking 1 month before surgery will improve your chances and also decrease your chance of pulmonary problems, however, the damage of years of smoking does not go away in your blood vessels.

Talk to your surgeon regarding his/her thoughts on smokers. Sometimes a slightly more conservative tuck may be warranted, but your chance of complications still exists.

Ricardo Izquierdo, MD
Oak Brook Plastic Surgeon
4.0 out of 5 stars 8 reviews

Smoking Increases the Chance of Necrosis

Stopping your nicotine use (in any form) a month prior to surgery lowers your chances of necrosis, but it can still happen. Even former smokers who have quit are still at increased risk of healing complications.

Decisions in surgery, such as how much to loosen the skin before removing the excess, and whether or not to do liposuction are also important. Overly-aggressive surgery is certainly one reason necrosis can happen.

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 242 reviews

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.