18 years smoker wants Mommy Makeover. Any suggestions?

Hello everyone, so i've been smoking since i was 12 :( yes 12 and on my late teens ive been smoking on average of 1 pack a day till this date. I am 30 now. I had 2 c-sections, twins on my first when i was 16 and with my boy 3 years ago.. can i still do this surgery? If i stop 6 weeks prior? Will it be safe for me?

Doctor Answers 14

Mommy Make-over, Tummy Tuck, Liposuction, Breast Lift, Breast Augmentation, Smoking

That is a great and honest question. And a very important one to be honest with your surgeon about. Some patients will cover up their smoking and all that can do is cause higher risk for increased healing issues. Nicotine in the tissue causes blood vessels to constrict and decrease the blood flow to the tissue as you are healing. The blood flow to the tissue is very important to heal properly or you can end up with open wounds, healing issues and even dead tissue. These are very serious complications that can be avoided by not having nicotine present in the system for 6 to 8 weeks before and after the procedure. This is especially important in surgeries that require more disruption of the blood vessels.

For instance, when I am doing a tummy tuck, some of the blood vessels that normally carry blood to the skin of the abdomen are divided in order that that the skin can be moved around to give a flatter, better shape to the abdomen. However, we leave enough other blood vessels intact so that the skin will heal. If there isn’t an adequate amount of blood flowing to the skin, the tissues will not get enough oxygen (a condition known as ischemia), and some of the tissue will die or not heal. That’s not a good situation. But the same thing is going on with many other operations like facelifts, breast lifts, breast reductions and many complex reconstructive cases. So, we have to make sure that we have left adequate blood supply to the tissues that we are moving to insure healing.

In order to have adequate circulation, we must not only leave enough blood vessels intact, but must also make sure that the blood flows through these blood vessels is sufficient. Certain things can affect this blood flow and one of the biggest is cigarette smoke and nicotine present in the tissue. Although nicotine in the cigarette smoke is the most dangerous element, the carbon monoxide and the hydrogen cyanide don’t help much either.

Smoking Makes You Need More Anesthesia and Pain Medication
A recent study (June 2015) presented at the European Society of Anesthesiology confirms what we have long suspected in the operating room. Compared with people who don’t smoke, smokers needed 33% more anesthesia throughout the operation and an additional 23% more pain medication after their procedure to achieve the same results. But the study went further. Those who didn’t smoke themselves but were exposed to secondhand smoke required 20% more anesthesia and 18% more pain medication than non-smokers who weren’t exposed to second hand smoke. Ouch.

Nicotine Prevents Healing Well
Nicotine causes the blood vessels to constrict which means they decrease in their size (diameter) and blood flow thorough them drops off. The nicotine can also make the blood clot more easily which can further clog small blood vessels and capillaries. All in all, these effects are extremely serious because they decrease the blood supply to the tissues, can result in wounds not healing, and can result in some devastating complications.
Smoking’s Particular Impact On Plastic Surgery Recovery
Many people who smoke tell me that they have never had healing problems before, so why should it be a problem now. What we are doing when we are moving tissue around in plastic surgery operations, is much different than — say — in a hysterectomy. Because in this operation, the tissues are not moved around in the same way, and the blood supply to the skin is not altered. (Now, I’m not saying that you won’t have a complication with a hysterectomy if you smoke, but you are at greater risk with some of the operations that I do.)

I hope this explains the seriousness of elective surgery and smoking and that you will only go to a Board Certified Plastic Surgeon and be completely honest.

Smoker 18 years, wants Monny Makover

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 patient 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 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

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 16 reviews

Mommy Makeover for Smoker

Hello and I definitely appreciate your question. I can tell you that being a regular smoker will definitely affect your healing process in any procedure you get, that is why most doctors request that you quit for a certain amount of time before surgery and throughout healing to make sure that incisions close and heal properly. You can always take this question to your surgeon in order to get his specific feedback as well.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Smoking before surgery is dangerous

There are certain plastic surgery procedures that become especially risky in smokers due to poor blood flow to the skin or other tissues. These include surgeries that are often part of a Mommy Makeover, such as a tummy tuck or breast lift. Smoking can result in death of some skin or the nipples and areolas, with delayed wound healing. Most plastic surgeons recommend that patients stop smoking COMPLETELY for at least 4 weeks before such surgeries. This means not a single cigarette, and no substitutes either like nicotine patches or gum, e-cigarettes, vaping, etc. Please discuss this honestly with your surgeon. 

Andres Taleisnik, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 36 reviews

Mommy Makeover - Smoking?

Thank you for your question. Smoking in the peri-operative period has been shown, in multiple studies, to result in a higher complication rate. I require my patients to stop smoking at least 4 weeks prior to surgery and not smoke for 4 weeks following the procedure. Please make sure you are cared for by a board certified plastic surgeon and have an honest discussion him or her regarding this. Hope this helps and good luck.

Smoking and Mommy Makeover

It is important to have a thorough history and physical performed prior to any elective procedure. Generally speaking if you are healthy overall and stop smoking 3-4 weeks prior to surgery and continue to stop 3-4 weeks after (ideally forever), you should still be able to undergo surgery without the higher risk of complication associated with smoking. If you relapse and have a cigarette anytime within the four weeks, then you should wait another four smoke-free weeks before proceeding with surgery. You are doing the right thing in taking the first step to stop smoking. Best of luck!

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 12 reviews

How long to stop smoking before a Mommy Makeover

You should check with your surgeon on this. For my patients I require a minimum of two weeks prior to surgery, if you stop smoking six weeks prior to surgery, you should be OK, however you need to continue to stop for a minimum of two weeks after surgery or what your surgeon recommends. Hopefully you can keep from starting again! Good luck!

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 68 reviews

Smoking

I have a lot of experience with smokers and plastic surgery.  I recommend stopping 3 weeks prior and after the  surgery.  I have done face lifts, breast augmentation and tummy tucks on smokers with great results.  One of the things we recommend is hyperbaric oxygen therapy a few days prior and after the surgery.  This helps the tissues heal better by bringing in more oxygen to the tissues.  Best to go to a board certified plastic surgeon who has experience with this.   Good luck!

Andrew T. Cohen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 37 reviews

18 years smoker wants Mommy Makeover. Any suggestions?

I really like your positive attitude, knowing that you will quit smoking before the surgery. Your risk of wound healing issues will be close to normal if you go without cigarettes for that 6 weeks, but you have to be tobacco free after surgery too. Good luck. Stick to your plan and you will not only look better but you will feel better and live longer to be with your children and grandchildren. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Mommy Makeover and smoking

Thanks for your question. If you stop smoking 6 weeks prior to your procedure as well as during the entire healing process (at least 6 weeks), you will decrease the risk of delayed healing after your procedure.
Good luck!

Brian Widenhouse, MD
Charleston Plastic Surgeon
4.1 out of 5 stars 36 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.