Female, 56, 5’5, 157lbs & I am a smoker - why can I not have implants?

Question

Updated: female age 56 height 5’5 weight 157 pounds. I do smoke, just want implants

Finny George, MD · Answer

Hi, thank you for sharing your question. There is an increased risk of wound healing complications and infection in patients who smoke and have surgery. Not just implants, any surgery. Discuss these risks with your surgeon and see if there is a way for you to work towards having implants.

Donovan Rosas, MD · Answer

Nicotine causes vascular constriction which can compromise healing.

In the case of any elective surgery, smoking cessation should be undertaken for a minimum of 6 weeks pre-op. This restriction includes any and all nicotine delivery systems (patches, gum, e-cig).

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Brian K. Reedy, MD · Answer

Thanks for your question!
I am assuming the surgeon will not operate on you because you are a smoker. Nicotine delays healing and causes wound issues. Stop smoking 3 weeks before surgery and for 3 weeks after.  Best wishes!

Leila Kasrai, MD, FRCSC · Answer

Smokers can get breast implants however they will need to refrain from smoking for a period of time before and after their surgery. This is to reduce the risks, such as necrosis and delayed wound healing.

John L. Burns Jr., MD · Answer

You'll want the best results for your breast augmentation.  Smoking cessation around the time of surgery will give you the best outcome.

Gerald Minniti, MD, FACS · Answer

In general, smoking patients experience a much higher rate of complications after any procedure. Most surgeons say absolutely not when surgeries requiring skin excision are contemplated (facelifts, breasts lifts, tummy tucks). With regards to implants, you are at higher risk for capsular contracture, which will likely send you back to the operating room. It's really simple: find a surgeon who doesn't care or stop smoking for 4-6 weeks prior to surgery.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I agree that there are some surgeries in which smoking does impact the outcome significantly.  These include anytime you are undermining the skin or creating skin flaps which would include facelifting, rhinoplasty, tummy tucks, or performing breast lift surgery.  Leave that a standard breast augmentation does not fit that criteria and would be fine if you cut down on your smoking considerably in the perioperative period.  Best wishes to you.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Ronald J. Edelson, MD · Answer

If you only need implants and not a lift it is perfectly safe to have done. If you have a lift the concern becomes the circulation to the nipple

Connie Hiers, MD, FACS · Answer

If you want implants, then stop smoking. With smoking you have increased risks of wound healing problems, poor circulation to your tissue, and coughing.  Most of us have seen way too many problems from smoking and refuse to do elective surgery on smokers.  There is no "just" in surgery with smoking.  At 55, you have done enough smoking. It is time to quit!