Should I stop smoking before breast implant removal?

Question

I have been told I need to stop smoking four weeks before and four weeks after my operation how important is this ? I'm worried i might find this too difficult

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 breast surgery 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 the incision alone, maximizing blood flow to the tissue is critical. Typically, we recommend at least 6 weeks of smoking cessation prior to any surgical procedure. Nicotine always increases the risk for infection and wound complications, as well as other health consequences. The smoking will likely impact vascularity, but I would discuss this with your surgeon prior to your procedure and ask other alternatives or assistance with smoking cessation.  Hope that this helps! Best wishes!

Ankur Mehta, MD · Answer

Hello and thank you for your question. Smoking can increase the risk of complications to any surgery. It can affect the bodies ability to heal and fight infections. If you continue to smoke you should make sure to be open and honest with your plastic surgeon and then let them decide on how comfortable they feel performing the operation. If you continue to smoke however, you have to understand that your risks of complications are significantly higher than someone who doesn't smoke. As stated below, this includes any type of nicotine supplement. If you are having trouble quitting you can discuss this with your PCP or plastic surgeon and may consider medication that helps you quit smoking (ie. Chantix). However, these meds also have risks associated with them so you should have a in depth discussion about these meds before taking them. Wish you the best of luck in quitting smoking!Ankur Mehta MD

Michael A. Epstein, MD, FACS · Answer

Smoking increases your risks of problems with wound healing and anesthesia.  Some surgeons may do the surgery on smokers, while others are more cautious.  Pneumonias after surgery, or wound problems requiring prolonged dressing changes and a poor result from the scarring are no fun.  Are the cigarettes worth that risk to you?Best,Dr. Michael EpsteinMAE Plastic SurgeryNorthbrook, IL

Robert Cohen, MD · Answer

Smoking cigarettes does two major things that hurt your ability to heal properly. First, the nicotine constricts small blood vessels which supply oxygen to the tissues.  Secondly, the smoke contains carbon monoxide which binds to your hemoglobin and also reduces oxygen carrying capacity to the tissues.  Oxygen is what helps you heal and fight infections.  As a result, smokers are at much higher risk for wound healing issues and infections. Since this is elective surgery, you owe it to yourself to do everything possible to minimize your risk of complications.  Quitting cigarettes is difficult, but just like you would quit during a pregnancy to protect the baby, you need to quit now to protect yourself.  A month before and after is a very reasonable timeframe to make sure you have the best results possible.

Gary L. Ross, MBChB, FRCS · Answer

Your risks and chance of complications are increased as a result of smoking and if you can't give up then the pros and cons of removing the implants at this time need to be discussed with your PS.

Charles W. Spenler, MD · Answer

Thank you for your question! In order to ensure you have the absolute best result with the fewest complications, I would recommend that you quit smoking at least 4 weeks before surgery and do not smoke for 4 weeks after surgery while you are healing. The nicotine in cigarettes decreases blood flow to the healing tissues which can cause a variety of complications including your nipple dying. While this does not necessarily happen to every patient, the risk is greatly increased by smoking which is why I would recommend that you quit. At our practice, we do allow patients to use vape as long as there is no nicotine. You cannot use the patch during the 4 weeks because that contains nicotine. Because of this, I recommend that my patients begin using the patch prior to the 4 week mark so that they are not quitting cold turkey. Breast surgery is an investment and I think it would be best to maximize your result.

Jeanette Padgett, MD, FACS · Answer

You need to stop smoking (no nicotine)  before surgery in order to decrease your risks of wound infection, poor healing of the surgical site, loss of tissue, and other pulmonary or cardiac complications.   No nicotine means not just quit smoking, but that also means don't vape, patch, dip or  chew nicotine.  The risk of smoking is real.  Don't jeopardize your surgical results with nicotine.   Investigate classes to help you quit smoking.  Best wishes.

Camille Cash, MD · Answer

Thank you for your question.  Smoking can be disastrous when it comes to surgery.  It increases chances for infection, poor wound healing including tissue loss, and increased risk of blood clots.  It is simply not worth it.  It is important to note that you must abstain from nicotine in any form- gum, e-cigarettes, the patch, etc.  Nicotine is the culprit, not just cigarettes.  I advise you to heed the advice of your surgeon.

Steven Wallach, MD · Answer

This is very important. Smoking impairs wound healing on many levels and can increase complication rates significantly.

Connie Hiers, MD, FACS · Answer

Smoking increases risks and may make your healing more difficult. The sooner you stop smoking, the better you will heal. If you are investing a fair amount of money and time to have elective surgery, you need to find a way to stop smoking so you will have the best results.

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