Does Smoking Cause Open Wounds and Infection on a Breast Reduction?

 
Cigarette smoke contains nicotine.  Nicotine causes vasoconstriction.  Vasoconstriction causes less blood to flow into tissue.  Less blood means less oxygen.  Therefore nicotine causes less oxygen to flow into tissue.  When wounds are healing and they are pulled tight, the flaps rely on small blood vessels for oxygen.  If the small blood vessels are constricted due to nicotine, the tissues will not receive oxygen.  When tissues do not receive oxygen they break down and can cause open wounds which can secondarily become infected.  Therefore nicotine is bad for wounds. However smoking, per se, does not cause open wounds or infection, but leads to poor healing, which can cause open wounds and subsequent infection.
 
Thank you,  
 
 
 
 
J. Timothy Katzen, MD,

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.

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.

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 mastopexy 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. Hope that this
helps! Best wishes!

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. 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.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

At a cancer center here in Houston, they will have the patient undergo a serum or urine cotinine test to see if a patient has recently used tobacco, and will cancel the surgery until the patient stops using tobacco.  Nicotine causes blood vessels to shrink In size, thus decreasing blood flow to certain areas.  When a surgery is done, whether a breast reduction or other, blood flow is lost to certain areas and has to come from another sometimes distant source.  This can potentially lead to tissue necrosis with nicotine use as the blood just can't make it through the shrunken blood vessels.

The surgeon is looking into your best interest when he or she says to not smoke, as they want you to have a good outcome from your surgical experience.

Smoking can impair wound healing based on reduced blood flow to the flaps. I do not see a basis for confusion. If you have not had this type of surgery, you cannot extrapolate by comparison to minor wounds. I recommend that you try a smoking cessation program and delay surgery until you have successfully completed it.

Smoking increases the risks of complications with surgery.  There are some reports that it increases the risk by 50%!

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

In short - smoking and all nicotine products are extremely harmful to normal healing after a breast reduction.  So much so that I will not perform an operation on any patient who has been smoking or taking nicotine product for 4 weeks prior to surgery.  Having surgery has enough inherent risks and adding smoking to this list unnecessarily adds more.  Best wishes.