Five Days Smoke Free Before Body Lift?

I am having torsoplasty (body lift) in five days and just stopped smoking today. Will five days smoke-free prior to surgery aid in my recovery as long as I continue not to smoke afterwards?

Doctor Answers 22

Body lift and smoking

If I were your surgeon, I would cancel your case.  These body contouring procedures put a lot of stress on the blood supply of the skin and your chance of delayed wound healing and really bad scarring is much increased.  Also, smoking screws up your lungs and increases secretions that can be a problem with general anesthetic.  Smoking also increases your chance for blood clots.  I turn smokers away and tell them to come back with they are non-smokers. They also have to be weaned from all nicotine replacements such as patches or gum. 

 I used to do the no smoking a month before and month after thing but patients cheat, their skin dies and they blame their surgeon.  Yet again, I learned the hard way.

Lisa Lynn Sowder, M.D.

Seattle Plastic Surgeon
5.0 out of 5 stars 72 reviews

Smoking and cosmetic surgery

It is well known that tobacco use (smoking) hinders healing potential and increases your risk of healing problem. It is great that you have stopped smoking for 5 days.  But I generally recommend for a body lift that my patients are tobacco free for at least 4 weeks before and definitely after surgery.   Your body lift is an elective procedure and you want to do your best to optimize your healing potential.  Even being tobacco free does not erase your past history of smoking as you will likely not heal as fast as as a nonsmoker.  But being tobacco free before and after your surgery is the best that you can do. Keep up the good work with being a non-smoker!

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 210 reviews

The SMOKING curse !

Unfortunately the smoking curse affects many people and is the bane of Plastic Surgeons worldwide. Nicotine, the drug that is delivered to your body when you smoke, is actually the culprit that causes the most immediate trouble when it comes to Plastic Surgery, however.  This drug causes blood vessels to clamp down and thus restricts the blood flowing through the blood vessel.  This is quite important because blood has the job of carrying oxygen to the tissues in your body and all tissue in your body needs oxygen to live and stay healthy. When a surgeon does a Body Lift or a Tummy Tuck they have to undermine tissue and thus decrease the tissues blood supply, now there is a certain amount of redundancy of blood supply that will in most cases be enough to allow the procedure to heal without difficulty. However, when you add the affects of the Nicotine to the mix, that amount of redundant blood supply is dramatically reduced and therefore increases the risk of complications to approximately 35%!!  That is a very large complication rate!  Also you should know that the affects of one cigarette on the blood vessels lasts for 18 hours!  Bottom line, you should not have this kind of procedure unless you stop smoking for at least one month or six weeks and even then we know that your risk does not decrease to the level of a non-smoker for over a year. Also remember, it is the Nicotine that is the culprit, so if you take the patches or chew the Nicotine gum you are doing the same thing as smoking as far as your blood vessels are concerned!

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 109 reviews

Smoking cessation before body lift surgery

I would say that 5 days of smoking cessation is not enough time for your body to metabolize the negative chemicals contained in tobacco as well as allowing your lungs to recover from smoking. Usually it will take at least 3 weeks to clear your system of these effects. If you quit now you may be looking at prolonged healing, wound break down, as well as pulmonary problems and even pneunomia.

This is your body and your money. Consider it not worth the risk. 

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.9 out of 5 stars 46 reviews

The Risks Of Cigarette Smoking

It's not unusual for cosmetic surgery patients to smoke cigarettes. When patients smoke cigarettes, they have an increased rate of complications. This occurs for several reasons including constriction of blood vessels and decreased oxygen carrying capacity of red blood cells. This can result in decreased blood flow and decreased oxygen delivery to the skin and subcutaneous tissue. Unfortunately, cessation of cigarette smoking only five days prior to surgery won't lower the risks of this activity.

Patients who smoke cigarettes have a higher incidence of wound breakdowns, open wounds, tissue necrosis, infection and scarring. For these reasons, surgeons are very cautious when treating patients who smoke cigarettes or use nicotine products. The risks vary with the type of procedure performed. Procedures that involve extensive undermining of skin such as facelifts, abdominoplasty, lower body lifts, breast lifts and breast reductions are associated with high complication rates.

In an effort to minimize complications associated with cigarette smoking, we recommend not smoking for 4 to 6 weeks prior to surgery. We also recommend not smoking for at least one month following surgery. This approach is modified based on the type of procedure performed.

If you have questions regarding cigarette smoking and your surgery, make sure you discuss them with your surgeon. Your surgeon should be able to discuss your risk factors.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Smoking and body lift

Absolutely not!  If I were your surgeon, I would not perform this surgery on anyone who is actively smoking.  This is due to the well-known negative effects of smoking on pulmonary function, microvascular circulation, and venous thromboembolism.  I require patients who smoke and are considering major elective surgery involving large skin flaps (and your case is such a situation) to completely stop smoking at least 6 weeks.  Most other respected plastic surgeons would probably concur with these or similar recommendations.  You might be able to find a surgeon who would proceed with your case while you are an active smoker, but this surgeon does not have your best interests at heart and you should probably avoid them. 

Jeffrey D. Wagner, MD
Indianapolis Plastic Surgeon
4.9 out of 5 stars 26 reviews

Smoking and surgery

Here are the major points of smoking Tobacco or Marijuana before or after 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. In a rhinoplasty the tip of the nose and the columella, the area between the tip and the lip, is at risk. Your skin and tissue can turn black and fall off if this happens. 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. Hookah also does not decrease nicotine.
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.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

Smoking Cessation Prior To Surgery

Nicotine causes small vessels to go into spasm which prevents blood flow through these areas.  The decreased blood flow means a lack of oxygen where it is most needed.  As a smoker, you are more likely to have delayed healing, wound disruption, and wound infection.  Four -six weeks off of tobacco is really in your best interest with this important undertaking.  Be honest with your surgeon so that neither of you will regret this undertaking.

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 114 reviews

Smoking and surgery

Thank you for your question.

I do not think that 5 days of being smoke free is good enough.  In my practice, I suggest that patients are nicotine free for at least 4 weeks prior to this type of surgery.  Smoking increases your risk of wound healing problems after surgery and so the longer you can be off of nicotine, the better for your recovery.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Must stop three weks before

I reccommend patients stop smoking at least three weeks before and three weeks after.  This includes no nicotine patches.  You are at greater risk for wound complications with five days of smoking cessation.  Does your surgeon know?

Vishnu Rumalla, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 197 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.