Using tobacco brings a significant risk of cancer, stroke, heat attack, etc. From a Plastic Surgery standpoint it is a vasoconstrictor. Wound healing is all about getting oxygen and needed entities to the wound. It is well known that patients who smoke have a tremendous increase in their rate of serious complications, (infections, wounds falling apart, etc.). Nicotine is the main vasoconstrictor, so getting a patch or lozenge of nicotine won't help the vasoconstriction. Best to be off the tobacco/nicotine entirely before surgery. Please be honest with your Board Certified Plastic Surgeon. Together you can make a plan to quit and proceed with surgery. The amount of time between quitting and surgery will depend on the Plastic Surgeon and the procedure.
Thanks for you sharing your concerns with us.
It depends how long you have been smoking. Generally I recommend to stop the use of any tobacco one before surgery and two months after.
Dr. Emmanuel Mallol Cotes.-
Nicotine has an extremely negative impact on your
wound healing. Because nicotine constricts blood vessels, it reduces the oxygen
needed for wound healing, possibly resulting in dead tissue. If you can’t stop using nicotine completely for four weeks before and four weeks after (a total of two
full months) then do not have the surgery.
In my practice, I ask patients to undergo smoking cessation 6 weeks before and after surgery. Good luck and be safe.
John T. Nguyen, MD, FACS, FICS
Double Board Certified Plastic Surgeon
Usually most surgeons will use a cotinine test. Half life is about 21 days. So 6-8 weeks should be your goal before elective surgery. This is usually the amount of time needed for the negative effects of nicotine to fade to acceptable levels. good luck.
Thank you for your question. Best to refrain from all nicotine-containg products for at least 4 weeks before and after. Procedures like a tummy tuck or a facelift are very sensitive to the effects of nicotine on the tiny blood vessels in the skin. Smokers/tobacco users have a much higher rate of wound complications with these procedures than non-smokers. Good luck.
Every body is different based on BMI, health status, age, etc. So the metabolism of the nicotine cannot be estimated in general. A tummy tuck, and any body excisional contouring surgery requires skin to be removed and a flap advanced. Smoking (nicotine) impairs blood flow, and there is a significantly higher risk of complications. I'm sure you are aware. I tell all my smokers interested in body contouring to Google image search "smoking tummy tuck". It is terrifying for the patient, but is also stressful for your PS. I will not perform any excisional body contouring surgery on smokers unless complete cessation 6 weeks before, and 6 weeks after surgery. A waiver consent is obtained prior to surgery agreeing to random nicotine testing, canceling surgery if needed. Every PS has had to deal with smoking complications. It is not our choice. It is usually the patients who cannot stop. Our recommendations are there to minimize complications and improve outcomes. It is for your safety.
Smoking cessation has many other benefits: save $$$, decrease the facial aging process (smokers faces age at least 25% faster), decrease cancer risk, decreased medical problems, live longer, and much more. So please consider stopping.
I hope that helps and good luck.
The reason for stopping smoking and tobacco use before surgery is the nicotine they contain. Nicotine causes vessels to go into spasm and reduces blood supply to the tissues. If the surgery also reduces blood supply, then nicotine markedly increases the risk that the wound will have problem healing or some skin to tissue will die. the nicotine also interferes with the normal lung function making anesthesia more risky. Therefore, any product containing nicotine, including electronic cigarettes and nicotine gum and patches, should be avoided before surgery. For a tummy tuck and any other surgery that reduces blood supply to the tissues, I believe that 4 weeks avoidance is the minimum, as it takes at least that ling for the vessels to recover to near normal. Longer is desirable.
Cigarette smoking is harmful for surgery because the smoke inhaled during smoking causes constriction of the arterioles which supply blood and oxygen to the tissues, especially the skin necessary for healing after surgery. Although it takes time for the effects of smoking to dissipate, the longer before the surgery that you can stop smoking the better. I think that if you completely stop one week before tummy tuck surgery, it would be safe to proceed with your surgery. But if you can allow more time, it would be better and safer.
Thank you for the question. I will ask my patients to stop smoking and avoid nicotine containing products for at least 4 weeks prior to and 4 weeks after their surgery. The nicotine restricts the blood flow within the tissues leading to wound healing problems (skin necrosis, infection, dehiscence, etc.). I hope this helps. Best wishes.