Smoking And Gynecomastia Surgery. Is this why have I have swelling? (photo)

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.

The male breast is composed of glandular tissue and fatty tissue. An excess in either type of tissue can cause the chest to take on the look of gynecomastia. Gynecomastia can affect #men of all different body types. There are different types of #gynecomastia.Several common factors can cause gynecomastia including excessive levels of #estrogen, natural #hormone changes, use of recreational drugs or alcohol, medications and their associated side effects, and, various health conditions. Also, there are different types of #gynecomastia. Therefore, weight gain, steroid use,recreational drug use and have hormonal conditions can contribute to a return of gynecomastia regardless of previous surgical removal and treatments.

Thank you for sharing your question and photograph.  Though resuming smoking is never advised, after 6 weeks it is doubtful that it is impacting your results.  It would not be uncommon to still have swelling as a result of your liposuction but other considerations exist - discrete fluid collection, residual glandular or adipose tissue.  See your surgeon for an in-person examination. They should be able to diagnose the cause of your current appearance and offer treatment recommendations. 

If you had liposuction and gland excision, it is possible you just have swelling that will take time to go away. Swelling from lipo is not completely gone as early as 6 weeks, even without smoking. Smoking does add the risk of slower healing or wound healing problems. Nicotine causes blood vessels to temporarily constrict (or tighten, shrink), and this means less blood flow which is not good when you are trying to heal a surgical site. I would recommend seeing your surgeon to make sure there is nothing else going on like a seroma (collection of fluid under skin). Mild compression and avoiding salty food may help the swelling go away faster too.

Thanks for sharing your concern, and it’s completely understandable to feel anxious when recovery isn’t going the way you expected. Let’s break this down and give you some clarity.
Can Smoking Affect Gynecomastia Surgery Recovery?
Yes, it absolutely can. Smoking whether it's cigarettes, vaping, or marijuana can impair healing after surgery in several ways:
• Reduced blood flow: Nicotine constricts blood vessels, decreasing oxygen and nutrients to healing tissues.
• Delayed healing: Poor circulation slows down the recovery process and can cause prolonged swelling or even tissue necrosis in severe cases.
• Increased inflammation: Smoking may worsen post-op inflammation, leading to swelling that lingers longer than normal.
• Reduced immune function: Your body may struggle to deal with internal bruising or fluid buildup properly.
At 1.5 Months Post-Op – Is Swelling Still Normal?
Some mild swelling and firmness (especially under the nipple area) can persist for up to 3–6 months after gynecomastia surgery. However, if your swelling hasn't improved at all, feels hard, hot, or painful, or if one side appears larger than the other, it may not be part of the typical healing process, it could indicate fluid buildup (seroma), fibrosis, or scar tissue, and should be evaluated by your surgeon.
What You Should Do Now
1. Stop smoking immediately. Even stopping now can help reduce further complications and aid recovery.
2. Contact your surgeon. Don’t wait. Let them know about your ongoing swelling and history of smoking. They may want to:
o Examine for fluid buildup or scar tissue
o Possibly drain a seroma if needed
o Recommend massage or ultrasound therapy
o Reassess your compression garment usage
3. Wear your compression vest consistently, if you're still within the wearing window. It helps control swelling and shape the chest.
4. Don’t self-diagnose. Only a hands-on evaluation can confirm if it’s just swelling, fibrosis, or something else.
Your surgeon will work with you on the best way to help heal and recover.

You do not provide a preop picture so I can't comment on your result, although it looks pretty good. Two weeks is way too early, so relax.

You didn't do your self any favors with smoking after surgery although I doubt, at this stage, you have done any permanent harm.

Talmage Raine MD FACS

drraine.com