Smoking before breast augmentation? Having local anesthesia.

My PS told me not to smoke two weeks prior. I'm having a really hard time with this. I'm wont be completely under since he does local anesthesia. I'm getting saline, and I will be awake the whole time even able to check the results at the end and go bigger if I desire. I have slowed down greatly. I don't smoke at all during the day, but evenings are torture. What are the complications if I continue smoking a few a day? Thank you all so much for your time answering my question.

Doctor Answers 17

Smoking before breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Although smoking is a general risk before any surgical procedure, breast augmentation does not have a specific increased risk with smoking unlike a breast procedure like a breast reduction or lift. However, avoiding smoking (actually nicotine) is a standard protocol these days and two weeks of no smoking (nicotine) is supposed to make the difference. 
The risk, in my opinion, is not from the smoking and is not an issue for a procedure under general anesthesia compared to a procedure under local anesthesia with sedation. Smoking risk is a long term thing, not related to the surgery in the short run. The risk is from nicotine in your system which affects blood flow and healing after the procedure. Obviously you don't want to work against proper blood flow and healing after your procedure. Once you are healed by about two weeks then returning to nicotine use would probably have little effect on your surgical result. It is not totally clear that effects of nicotine use last two weeks but it makes no good sense to do an elective surgical procedure and increase your risks of a poor outcome. If you can't keep the nicotine out of your system before the surgery, I wouldn't proceed with it. 

Boulder Plastic Surgeon

Smoking should be avaoided

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I advise all my patients to avoid smoking , as its associated with anesthesia risk and risks of wound healing problems. But in reality I know that some of them don't follow my advise and smoke without bringing it to my notice. So far I have not had any complications related to smoking, as I suppose most of them do stop or reduce drastically. 

Priti Shukla, Mch
India Plastic Surgeon
5.0 out of 5 stars 39 reviews

Smoking pre aug

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is always best not to smoke but it is not as critic   with a breast aug unless the impalnt is too big and there is a tight closure.This could lead to an exposure of the

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 70 reviews

Smoking and breast augs

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hello. Your PS is absolutely correct in advising you to cease smoking prior to your BA. if you continue smoking you're  at risk for infection, poor wound healing, implant extrusion and loss, and even septicemia ( bacteria in your blood).  Please be safe and follow your surgeon's instructions. 

Dr. Burnett

Smoking before breast augmentation? Having local anesthesia.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question.  I would definitely relay your difficulty at stopping smoking with your surgeon so that the two of you can discuss your options.  Patients who smoke need to ideally stop all together, but at a minimum at least a month prior to, and after, surgery.  Smoking interferes in a number of ways to retard healing, but one of the major ways is through its constriction of your arteries, limiting appropriate blood flow to your skin and tissues to heal.  There is no reason to risk your health, and a complication, with an elective procedure by smoking.  Ask your surgeon or PCP about other smoking cessation methods that can help you wean yourself completely off.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Smoking and BA

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Most experts unanimously agree that smoking increases the rate of breast augmentation surgical complications significantly. Just about all plastic surgeons strongly recommend women to stop smoking and all nicotine products well in advance of breast augmentation with breast implants. Many plastic surgeons recommend stopping all tobacco products several months prior to surgery.
Here is the reason why: the nicotine in cigarettes and other tobacco products (including Nicorette gum, patches, etc) is a vasoconstrictor, meaning it makes the Smoking is a significant multiplier of many potential complications following surgery and breast augmentation with implants are no exception. Nicotine from smoking causes blood vessels to vasoconstrict ( tighten up). Over time, these constricted arteries and capillaries deliver less blood to the breast tissue which is needed for normal healing. Smokers therefore have an increased incidence of higher likelihood of complications such as infection, and in particular capsular contracture (hardening and distortion of the implants). General complications of surgery such as blood clots, anesthetic problems such as pneumonia are also increased.
A scientific article in the Archives of Internal Medicine indicated that, among all forms of surgery, quitting smoking eight weeks prior was never associated with an increased risk of complications.
In young patients you will probably statistically avoid these complications, why tempt fate by increasing your odds that something bad will happen.On a long term basis, smoking also causes accelerated aging of the skin and loss of elasticity. Hopefully these reasons will help give you the will power and courage to stop smoking.

Smoking and breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question. Smoking before or after your surgery can increase your risk of developing complications including infection and wound healing problems. I tell my patients that it is ideal to stop a couple months ahead of surgery and then for a couple months after surgery. Please discuss with your surgeon what their guidelines are for your particular surgery.

Smoking before breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Greetings. I would not recommend smoking before or after breast augmentation surgery. The risk of complications increases with the use of nicotine products. Your plastic surgeon is correct on this point.

Ravinder Jarial, DO
West Palm Beach Plastic Surgeon
4.9 out of 5 stars 18 reviews

Smoking and Plastic Surgery - #plasticsurgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is standard for plastic surgeons to request their patients to cease smoking one month before surgery.  The nicotine in smoke or patches or gum for that matter contributes to narrowing blood vessels and reducing blood supply.  You need blood supply to heal wounds and fight infections.  It is well established in Plastic Surgery and other studies that patient who smoke have more problems with surgery - more with wound healing than tolerating a general anesthetic.  Stopping smoking for one month does not take a patient down to baseline risks, but is about the minimum to blunt the effect.  You would have to stop smoking for many years to get down to baseline. Stopping smoking is more crucial for operations like a facelift , abdominoplasty, or breast lift where there are thin tissue sheets elevated.  Many patient stop for an operation then stay smoke free and any doctor will tell you that is the best outcome of all. 

Mark D. Wigod, MD
Boise Plastic Surgeon

Smoking cessation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for your question.  It is important for you to cease smoking prior to surgery as smoking increases risk of infection, capsular contracture, bleeding, bruising, poor wound healing and possible need for additional procedures.  We advise our patients to cease smoking a minimum of two weeks prior to surgery and to avoid smoking and secondhand smoke for 4 weeks after surgery.

Best regards,
Dr. Lane F. Smith, MD
Plastic Surgeon
Las Vegas, NV

Lane Smith, MD
Las Vegas Plastic Surgeon
4.6 out of 5 stars 98 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.