Smoking cigarettes 24 hours before breast reduction - should I cancel my surgery?

I was unable personally to stop smoking 2 weeks before my breast reduction surgery. My surgery is in 24 hours and my last cigarette was last night around 7pm. So I have been cigarette free for about 30 hours. Should I cancel my surgery?

Doctor Answers 8


I don't think you need to cancel your surgery, but be aware that smoking
increases the risk of healing problems because the chemicals in your
bloodstream reduce circulation to the skin. I advise patients to try and
quit 1 month before surgery as the effect of smoking tends to linger.
Make sure you advise the surgeon that you have not quit and he can then
ensure his surgical approach is more conservative so circulation
problems are less likely to occur.

Toronto Plastic Surgeon
4.4 out of 5 stars 8 reviews

Smoking before Breast Reduction

Yes, you should cancel your surgery even if it costs you a cancellation fee. The cost of any fee is less than the cost and aggravation of dealing with the complications of surgery caused by your smoking including pneumonia, skin, nipple or partial breast loss, wound healing problems, seromas or fat necrosis or other problems. I would not reschedule until you have stopped smoking for at least a month so you will know that this will not happen again.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

Smoking cigarettes 24 hours before breast reduction - should I cancel my surgery?

Yes, you should cancel your surgery.  Call your plastic surgeon and discuss with them the situation.  If you continue on and have the surgery, you risk having the breast tissue not heal or worse,  part of the breast  tissue may die.  The smoking, or any form of nicotine, should be avoided a month prior to surgery.  The nicotine constricts the blood vessels and limits the amount of oxygen to the tissue.  The lack of oxygen can cause the poor healing and tissue death.  Quit smoking and then have your surgery.  Best wishes.

Jeanette Padgett, MD, FACS
Oklahoma City Plastic Surgeon
4.5 out of 5 stars 10 reviews

Smoking cigarettes 24 hours before breast reduction - should I cancel my surgery?

Patients that smoke within 2 weeks before and after breast reduction surgery are at a significantly higher risk for soft tissue necrosis which means death of skin and or fat, including death and total loss of the nipple and areola. You seem to be making poor choices, don't compound that by having surgery. Until you can correct this issue you are not a suitable candidate for elective surgery. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Smoking and breast reduction

I personally think that smoking and breast reduction is a horrible combination and choose not to operate on women who smoke. The risk of skin necrosis and wound healing problems is entirely too high. 30hrs is not enough time for the nicotine to be out of your system, and realistically you will likely smoke postoperatively. Your healing could be horribly prolonged and complicated. Be honest with your surgeon please.

Kendall Roehl, MD, FACS
Webster Plastic Surgeon
5.0 out of 5 stars 10 reviews

Smoking cigarettes 24 hours before breast reduction - should I cancel my surgery?

I would tell your surgeon right away. Personally, I would not do a breast reduction on an active smoker as the risks are too high.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 70 reviews

Smoking and breast reduction

Thank you for your question.

Each plastic surgeon will have a different view on smoking. Personally I would not operate on active smoker for a breast reduction and frequently order a cotinine test if there is a question.  The risks are much higher with nicotine in your system. 30 hours without nicotine is not enough time to reverse the negative affects on wound healing. Our literatures suggests 4-6 weeks is required to normalize risk.

Ultimately it is up to you. My recommendation is tell your surgeon and you both can come to a decision.

Dr L

Andre Levesque, MD
Austin Plastic Surgeon
4.7 out of 5 stars 3 reviews

Smoking cigarettes 24 hours before breast reduction - should I cancel my surgery?

It will be in your best interest to be honest with your plastic surgeon; personally,  I would not suggest that you undergo the procedure unless you have the nicotine free for at least one month prior to the surgery.  Nicotine behaves as a vasoconstrictor of blood vessels thereby decreasing blood flow to tissues ( that need to receive blood flow to heal after surgery). A decrease in this blood flow may result in wound healing problems and/or tissue death.
Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,502 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.