I had my BA done 2 weeks ago and I have started to smoke a few days ago.Will it cause capsular contracture?

Question

Btw, my breast still swelling so I can't see the different if it is CC or swollen still. I will stop smoking now and start to do more massaging. Does it help to prevent the implant to grow harder? What should I do? Please advise!

Larry S. Nichter, MD, MS, FACS · Answer

Most experts unanimously agree that smoking increases the rate of  breast augmentation surgical complications significantly. Just about all plastic surgeons strongly recommend  women  to stop smoking and all nicotine products well in advance of breast augmentation with breast implants.  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 vasoconstrict ( tighten up). Over time, these constricted arteries and capillaries deliver less blood to the breast tissue which is needed for normal healing. Smokers therefore have an increased incidence of higher likelihood of complications such as infection, and in particular capsular contracture (hardening and distortion of the implants). General complications of surgery such as blood clots, anesthetic problems such as pneumonia are also increased. A 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.In young patients you will probably statistically avoid these complications, why tempt fate by increasing your odds that something bad will happen.On a long term basis, smoking also causes accelerated aging of the skin and loss of elasticity. Hopefully these reasons will help give you the will power and courage to stop smoking.

Young R. Cho, MD, PhD · Answer

Thank you for your question. Smoking before or after your surgery can increase your risk of developing complications including infection and wound healing problems.  I tell my patients that it is ideal to stop a couple months ahead of surgery and then for a couple months after surgery. Please discuss with your surgeon what their guidelines are for your particular surgery.

Lewis Albert Andres, MD · Answer

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 reduction where the viability of the
 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. There is no literature to support smoking and capsular contracture.  Hope that this 
helps! Best wishes!

J. Jason Wendel, MD, FACS · Answer

I know of no scientific literature stating that smoking causes capsular contracture after breast augmentation.

	In general, it is best to take the best care of yourself possible after surgery to promote healing.  Eat healthy and sleep well. Avoid heavy exercise until instructed by your doctor.

	Smoking is certainly not good for healing after surgery, but with respect to your question, no, smoking has not been cited as a cause for capsular contracture after routine breast augmentation.

Remus Repta, MD · Answer

Hello,

	We know that smoking can negatively impact healing.  I am not sure that there is any data that states it impacts capsule contracture.  Capsule contracture occurs months-to-years after a breast augmentation so it is still early for  that to happen for you.

	All the best,

	Dr Repta

Johan E. Brahme, MD · Answer

There is no scientific relationship between postoperative smoking and the development of Contractures. While smoking in general is not ideal for wound healing, it honestly plays a very small role with a routine breast augmentation. If you have recovered well so far, smoking probably will play little role in the eventual outcome of your surgery. Good luck

Robert L. Kraft, MD, FACS · Answer

The literature has not demonstrated a connection between smoking and capsular contracture. However, smoking negatively affects wound healing and scarring. Some patients use the respite from smoking in the immediate postop period as the impetus to stop smoking.

Tom J. Pousti, MD · Answer

Thank you for the question.

	I am not aware of any scientific literature that shows a causative link between smoking and capsular contracture. However, the use of nicotine will not be helpful in the postoperative period in regards to wound healing and/or pulmonary function.

	May be you can use this opportunity to stop smoking for good?

	I hope this helps.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  I do not believe there is any hard evidence that smoking will cause capsular contraction.  However smoking does interfere with blood supply and good blood supply is necessary for adequate healing after breast augmentation.  I complement you and your decision to quit smoking

I had my BA done 2 weeks ago and I have started to smoke a few days ago.Will it cause capsular contracture?

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