Fear of capsular contracture. Does smoking increase the risk?

Question

Does smoking cause capsular contracture? How soon can I smoke after breast augmentation? I cant enjoy my breasts cause of the risk of capsular contracture.

Randal Haworth, MD, FACS · Answer

Yes, smoking can increase the risk of developing capsular contracture after breast augmentation surgery. Capsular contracture is a complication that occurs when the tissue capsule around the breast implant becomes thickened and tight, causing the implant to feel hard and potentially causing pain or discomfort.

Smoking can impair blood flow to the breast tissue and interfere with the body's healing process, which can increase the risk of capsular contracture. The nicotine in cigarettes can also cause blood vessels to constrict, reducing the amount of oxygen and nutrients that reach the breast tissue and delaying healing.

For these reasons, many plastic surgeons recommend that patients stop smoking at least four to six weeks before breast augmentation surgery and avoid smoking for several weeks after the surgery.

In general, it's recommended that patients quit smoking altogether to reduce the risks associated with smoking-related complications and to promote overall health and well-being.

If you have concerns about capsular contracture, it's important to discuss these concerns with your plastic surgeon. They can provide personalized recommendations and advice on how to reduce the risk of this complication based on your specific situation.

Georges J. Samaha, MD · Answer

Hi. Yes, smoking increases the risk for capsular contractor. It also increases the risk of infection, wound complications, nipple necrosis and anesthesia complications.

Brian K. Reedy, MD · Answer

Hi & thanks for your question.
Smoking before and after surgery may cause complications and wound healing issues. It is important to not smoke 3 weeks prior to surgery and 3 weeks after. Best wishes!

Daniel Barrett, MD · Answer

Dear rainrain90,
capsular contracture happens. In fact, every implant has a capsule form around it, its just a certain percentage develop thick capsules. There is a lot we don't know about it actually. Some think that bacteria that gets on the implant during insertion can increase the risk. Thats why we use a Keller Funnel in our practice to reduce that possibility. Our capsular contracture rate is less than 2% because we use a keller funnel as well as meticulous operating room techniques.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Heather Vande Ven, DO · Answer

Yes, smoking is considered a risk factor or capsular contracture, a complication that can occur after breast augmentation surgery. Smoking may impede proper healing and increase inflammation, potentially raising the likelihood of developing this condition. It’s advisable to discuss any concerns about smoking and surgery risks with your healthcare provider before undergoing the procedure.

William Samson, MD · Answer

Thank you for your question. Although I'm not aware of any data to suggest that smoking increases her risk of capsular contracture, there is lots of data demonstrating the adverse impact of nicotine on general health and well-being. It is very admirable that you are able to discontinue nicotine use during the perioperative period. Hopefully this can be the catalyst for more long term smoking cessation.

Connie Hiers, MD, FACS · Answer

You should never smoke. Smoking does increase the risks of many complications, especially with blood supply to your breasts. Many surgeons will not operate on smokers.

Camille Cash, MD · Answer

Capsular contracture occurs when the capsule that forms around the implant thickens and tends to "shrink wrap" around the implant.  There are varying degrees to this and we are still learning more about why this occurs.  Smoking can contribute to issues with breast augmentation.  You are encouraged to stop using any nicotine several weeks prior to as well as after surgery.  I've included a video about capsular contrcture that I hope you find helpful.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.

Smoking after breast implant surgery can have several negative effects on your recovery.  Cigarette smoking causes constriction of blood vessels which can lessen the flow of blood to your surgical site and impede healing.

In addition there is evidence that cigarette smoking can lead to increased risk of capsular contracture.  I would strongly advise you to not smoke cigarettes after your breast augmentation.  Capsular contracture is a very unfortunate complication of breast augmentation, 1 that you do not want to experience.

Fear of capsular contracture. Does smoking increase the risk?

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