I am due to have breast augmentation in less than 2 days and I haven't stopped smoking cigarettes. Is that really bad?

Doctor Answers 21

Smoking Cessation & Surgery

Most patients are aware that smoking is a major risk factor of heart and respiratory diseases, as well as several types of cancer.  However, many patients are not aware that smoking leads to poorer outcomes from surgery. Because smoking can greatly impair your ability to heal, it is very important to stop smoking preoperatively and continue cessation after surgery as well. Smoking causes vasoconstriction and damages blood vessels which leads to decreased blood flow to tissues. Decreased blood flow and oxygenation of tissues then leads to poor wound healing. A poorly healed wound especially in the context of a breast implant can also increase the chance of infection. Overall, smokers have a higher rate of complications than non-smokers. It is important to be nicotine and smoke-free for at least 6 weeks prior to your surgery to prevent postoperative complications. Consult your board-certified plastic surgeon regarding the risks associated with smoking and surgery. Good luck with your body makeover!

Smoking Before Surgery

Dear pam131280, The body will always heal better if you have been off of your smoking habit for at least a week. It is not so much the nicotine; it’s the carbon monoxide that wrecks havoc on the circulation. In general, breast augmentation will not be that terribly impacted by smoking because there is not a disarrangement of the circulatory flow. However, the breast reduction or breast lift with smoking usually spells disaster with poor wound healing. I hope this has been helpful. Robert D. Wilcox, MD

Robert D. Wilcox, MD
Dallas Plastic Surgeon
4.1 out of 5 stars 13 reviews

Smoking Pre Op

You need to discuss this with your operating Plastic Surgeon. Smoking decreases circulation and your ability to heal could be impaired. They may or may  not wish to proceed with the surgery and you will need to understand that your risk of complication is higher. A smoker’s compromised immune system leads to a rate of post-operative wound infection that is six times higher than non-smokers.
All the best

I am due to have breast augmentation in less than 2 days and I haven't stopped smoking cigarettes. Is that really bad?

Any amount of nicotine will decrease the amount of blood flow to the tissue.  When having surgery, the decreased blood flow, and thereby less oxygen to the tissue, can leave you with delayed healing and possible tissue death. Talk with your plastic surgeon about this.  If you are having a lift with your augmentation, definitely postpone your surgery until you are off all forms of nicotine for 2 months.  Best wishes.

Jeanette Padgett, MD, FACS
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 9 reviews

Smoking and surgery, some advices:

Thanks for the question. In my practice I recommend to stop smoking at least 1 month before the procedure and to keep without smoking for 2 months. Kind regards,Dr. Emmanuel Mallol.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 147 reviews

Smoking before breast augmentation

Thank you for your question.  I advise my patients to stop smoking at least 2-3 weeks prior to having their procedure. There can be delayed wound healing resulting in unsightly scarring, skin loss, and potential nipple loss necessitating skin grafting. There can be infection around the implant requiring its removal. In all cases of patients exposed to smoke or directly smoking, wounds do not heal within the expected time frame. Wound healing can be prolonged, as long as 3-4 months. STOP NOW.  And please be honest with your plastic surgeon and staff if they ask.

Fred Hackney, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 20 reviews

Not Ideal

As you have read, and really know, smoking is not good for any operation.  It is especially a problem in those operations where skin is undermined extensively, like a tummy tuck, breast lift or facelift.  Its all about blood supply because oxygen is needed to heal tissues.  If you stopped now, I'm not sure if there is much benefit, although there can be some.  Fortunately, a straight breast augmentation is less of a problem (but don't think I'd rather you not be smoking).  Scarring at the incision site may be bigger.  Be honest with your plastic surgeon, he only want the best outcome for you.  It all about stacking the many variable, related to an operation and healing, in your favor.  Smoking is not in your favor.

R. McIntyre Bridges, MD
Shreveport Plastic Surgeon
4.5 out of 5 stars 2 reviews

Cigarette smoking and breast augmentation

Really bad?  Well .....  Studies show that a SINGLE cigarette smoked within the month before surgery DOUBLES the risk of infection.  The center for disease control (CDC) recommends that smokers stop smoking one month before surgery but note that longer is better.  Many studies recommend 2 months.  I recommend that my patients stop smoking for 2 months before and after surgery.  This includes second hand smoke.And smokers have a higher risk of infection, delayed healing, skin necrosis, pulmonary problems and wound dehiscence( the incision rupturing or separating).  And of course smoking makes you look older faster as well as increasing your risk of many kinds of cancer.  I know that this sounds a little strong.  But its completely true.  Having said that, the risk of having these problems after a simple breast augmentation is lower, so doubling a lower risk is higher than not smoking, but not so risky that it can't be done.  If you are having a breast lift (mastopexy) at the same time then you can have significantly more problems from smoking, and you should discuss this with your surgeon.  And make sure that you limit your activity after surgery per your surgeons recommendation (I recommend 6 weeks) to decrease your now increased risk of healing issues that could lead to the loss of your breast implant.  I would discuss this honestly with your surgeon to see you you are still an acceptable risk for the surgery that you are planning.  

Jonathan Hall, MD
Boston Plastic Surgeon
4.9 out of 5 stars 29 reviews

How "Bad" is bad when it comes to Smoking and Cosmetic Surgery?

Smoking or consuming Nicotine in any other fashion (chewing, patch etc) results in long term spasms and blockages of the blood supply in the skin and other organs. For proper healing to occur after surgery, the skin blood flow must be unimpeded in any way - including compression, cold or NICOTINE. If the vessels are in spasm you risk death of the edgres and areas near the incision and wound separation. This could result in serious and permanent complications. I would "come clean" with your surgeon ASAP.

Dr. Peter A. Aldea
Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 101 reviews

Smoking and Surgery

As you have read, smoking cigarettes and ANY form of nicotine (patch, gum, or vape) can negatively affect your healing.  For breast augmentation, the risk is probably lower, but your surgeon should know about this and make you aware of the risks too. 

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 253 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.