Smoking Marijuana After Breast Augmentation?

Question

I have quit smoking for two weeks now and just had my surgery today. I was wondering when its safe to start smoking again without risking C.C.? Obviously, you guys are going to say smoking is bad and this is a good time to quit but it truly helps with my anxiety and I'd rather smoke this than take xanex or anything other anxiety medicine. It's a natural way to lower my anxiety. I was thinking about 3 weeks after, what do you guys prefer? I really do not want to get C.C.! Thanks <3

Matthew Schulman, MD · Answer

The big problem that smoking causes with surgery is that it can cause healing complications. This occurs from nicotine and the other substances found in the smoke. Cigarettes in particular have multiple toxins in addition to nicotine. There have been no studies that I know of looking specifically at marijuana smoking and wound healing. The active chemical of marijuana, THC, probably has little effect on healing. If we believe that the real problem is the tars, toxins, and nicotine, then it seems to follow that smoking marijuana may not have as much effect on healing. Obviously speak to your surgeon honestly and openly. We as surgeons should be able to give you an honest opinion based on science and data, complelely separate from their own personal opinion about marijuana smoking.

Larry S. Nichter, MD, MS, FACS · Answer

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.

Young R. Cho, MD, PhD · Answer

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 generally ask patients to stop a couple months ahead of surgery and then for a couple months after surgery.

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question! The issue with nicotine, or any inhalational agent, is that it also acts as a vasoconstrictor, clamping down of blood vessels. Blood supply is always of great concern during any surgical procedure, but especially in such a procedure as a breast augmentation where the viability of the nipple-areolar complex is obviously important. Since the vascularity to the area is already tenuous with placement of the implant beneath, maximizing blood flow to the tissue is critical. Typically, we recommend at least 6 weeks of smoking cessation prior to and at least 6 weeks after any surgical procedure. The longer, the better. Nicotine always increases the risk for infection, nipple necrosis, and wound complications, as well as other health consequences.  The most devastating consequence of infection, especially since an implantable prosthetic device is used, is increased. This along with wound healing and scarring. I would discuss this with your surgeon prior to your procedure. Hope that this helps! Best wishes!

Jed H. Horowitz, MD, FACS · Answer

i am unaware of any association of marijuana and complications of healing

	 

	even the effects of tobacco and healing diminish after 2 4 weeks

Jeffrey J. Roth, MD, FACS · Answer

Some studies have shown that tobacco smokers have increased risks of capsular contracture. Smoking tobacco or marijuana is known to cause vaso constriction. Wound healing is all about getting blood flow to the wound. For these reasons, we ask our patient to refrain from smoking anything at least a few weeks before and after surgery.

Kenneth Hughes, MD · Answer

There exists no data studying this relationship. In my practice in Los Angeles, I have a great number of patients who have prescriptions for medical marijuana. I typically tell them to stop a week before and 6 weeks after, because the components and their effects are not fully understood. It would be very hard to determine at this point the long term effects on capsular contracture.

Scott C. Sattler, MD, FACS · Answer

I don't think post smoking its really going to impact your post-op result or promote capsular contracture. There are so many other factors that impact rates of CC - smoking is not one of them. If smoking pot makes you relax, then enjoy - its legal here in WA state now. Personally, I don't think smoking anything is health promoting, but the act of smoking pot should not impact your BA result.

Ronald Levine, MD · Answer

It’s better to ask your surgeon about this. I wouldn’t rely on the advice of surgeons who are unfamiliar with your situation.

Pablo Prichard, MD · Answer

Here are the major points of smoking Tobacco or Marijuana before or after surgery:1. There is nicotine in tobacco, but not in marijuana.  However, most joints are rolled with marijuana and tobacco combination.  Nicotine is a vasoconstrictor that decreases blood flow to the tissues.  This is the major problems that can cause a very bad outcome in some surgeries.  In a breast augmentation, there is not a lot of risk as there are not a lot of incisions which decrease blood flow to the tissues. In a breast lift or tummy tuck, on the other hand, there is much longer and more involved incisions. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die.  This can cause part of the breast or nipple, or in the case of a tummy tuck, part of the belly tissue to die, resulting in a very bad outcome.  Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion.2. There is carbon monoxide in both tobacco smoke and marijuana smoke.  Carbon monoxide decreases the oxygen carrying capacity of hemoglobin in the blood.  This is different from the vasoconstrictor effect, but has the same result of having the risk of tissue death in conjunction with surgeries that decrease the blood flow to tissues such as breast lifts and tummy tucks, as opposed to an augmentation alone that does not decrease blood flow to as great of an extent.  Again, edible forms of marijuana do not have smoke, and thus carbon monoxide poisoning.3. Coughing.  Both tobacco and marijuana smoke disrupt the lining of the lungs and bronchi and can lead to coughing episodes.  Coughing episodes can lead to internal bleeding after surgery that can lead to hematomas and complications, and again a bad outcome.  Again, edible forms of marijuana does not have this effect.4. Anesthesia effects.  Marijuana can have drug interactions with certain anesthetic drugs.  Thus it is important to tell your anesthesiologist about your marijuana use.In conclusion, Smoking, whether it be tobacco or marijuana, is detrimental to your surgery outcome.  Edible marijuana is much less so, but be honest about your use with your surgeon and anesthesiologist so that you can have the best outcome.Best wishes,Pablo Prichard, MD

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