How common is Necrosis, if you have smoked for 14 years, and I have 10 days before surgery and she said I need to stop?

Smoking can absolutely increase your risk for necrosis, wound healing problems, and infections. I don't know of any Board Certified Plastic Surgeon who does not require patients to stop smoking for at least 4 weeks prior to a tummy tuck. I find it hard to believe that your surgeon would agree to perform a tummy tuck on you 10 days from now, knowing that you are still smoking. The risks are real and well documented in the literature. You should certainly delay your surgery and perhaps you should also look for another surgeon who takes more appropriate precautions. 

Smoking 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.

I always insist that any patients undergoing a tummy tuck
quit smoking for at least three months preoperatively.If you would only quit for 10 days
preoperatively, I would think that your chance of getting a necrosis is incredibly
high.I would definitely postpone your
surgery.Best of Luck.

There is a significantly higher incidence of necrosis and healing problems in smokers versus non smokers. To reduce this risk we ask our patients who smoke to stop smoking 4-6 weeks before surgery. We ask them not start again for several weeks afterwards until we are sure healing is complete. Here is the difference between a c section and a tummy tuck: In a c section, the surgeon cuts directly through the skin--there isn't any undermining or lifting up of tissues. There isn't any removal of skin. In a tummy tuck, the excess skin is removed, the adjacent skin lifted up and shifted into position to close the wound created. A tummy tuck incision relies on blood flow from the adjacent tissue to heal it. In a smoker, nicotine and by products cause the blood vessels feeding the healing incision to clamp down so the wound gets less blood flow. I would not feel comfortable proceeding with this surgery at this point.   

not only could you get skin death but your likelihood of infection, wound healing problems, dvt all go up. listen to your dr. and while you are quitting for surgery, why not quit full time.  be nice to be around for those kids who caused you to need the tummy tuck in the first -place

   Thank you for your question. Smoking will greatly increase your chance of tissue necrosis. The best thing you can do is to stop 1-2 months prior to your surgery. You should google photos of abdominal necrosis after tuck to see what happens. This will make you aware of what to expect if you don't stop. Most board certified plastic surgeons do not take this issue lightly. 

smoking is a major concern with a tummy tuck.  a tummy tuck and C-section are completely different operations and done for completely different reasons.  if your surgeon instructed you to do so and you choose not to - then be sure you understand the months it could possibly take for the hole in your abdomen to heal in with daily dressing changes and wound care, after any necrotic (dead) tissue is removed.  simply put - it isn't worth the risk or aggravation for you or your surgeon to go through with a tummy tuck if you can't put the cigarettes down.  you should go online and try searching for pics of tummy tuck patients with necrosis - this should help you decide if it is worth the risk.

Thank you for your question.   You absolutely need to stop smoking!  If you do not stop smoking and proceed with a tummy tuck, you will have a wound healing complication and or necrosis.  The blood supply to the skin is compromised by the dissection which is far more extensive that a C-section.  The carbon monoxide and nicotine in cigarette smoke will cause the skin not to get enough blood to survive or to heal uneventfully. One or two cigarettes can cause a problem.   I would recommend rescheduling your procedure once you have been able to stop smoking to avoid a complication.  Typically, most surgeons have patients stop two weeks before surgery and a minimum of two weeks after surgery. Best wishes.

It has been stated that Plastic surgery is a battle between beauty and blood supply.  When performing a tummy tuck, we stress the skin and underlying tissue by dividing much of it's blood supply so that it remains dependent on vessels that were once just part of that blood supply.  Nicotine in any form will further decrease the blood supply to the tissue.  This can have catastrophic consequences.  If I can offer any advice, protect yourself.  If you have not stopped smoking, cancel your surgery.  Do not put yourself at risk.  You are undergoing a cosmetic surgery and you want a great result.  If you are smoking, you may end up with a large open wound, wearing a wound vac or performing dressing changes for a long period of time, and your scarring could be horrible.  In my practice, if someone chooses to quit, I will still check a nicotine test after they have told me they have quit for a certain time period.  If the test is positive, I will not schedule the surgery.  If the test is negative, I will schedule the surgery and check another nicotine test on the day of surgery.  If it is positive, I will cancel the operation because I don't want to cause harm.  Not all physicians are this strict, but I'm really looking after the best interests of my patients.  

Thanks for your question.  You are at a significantly higher risk of wound healing difficulties and skin necrosis if you smoke and have a tummy tuck.  In a C-section, the surgeon cuts straight down through the tissue and then repairs the tissue.  In a tummy tuck, the skin is lifted up and advanced down.  When the skin is lifted up, the blood flow from the muscles is cut and the skin is dependent on blood flow from the sides.  Additionally, there is tension (tightness) in the mid portion of the skin flap and this may also interfere with blood flow.  Best to stop for one month before/after surgery to minimize your risk of complications.  I have seen patients have skin necrosis with secondhand smoke and nicotine patches as well.  If you were my patient, I would not offer you surgery at this time.  Good luck.