Second hand smoking effect on fat transfer?

Question

Hi! I am planning to go on a holiday after my fat transfer procedure but I wanted to know the effects of passive smoking. For example can being on a restaurant/bar terrace or balcony where people are smoking affect the fat retention results? Even at 10-11weeks post op? Or should I postpone my trip. Should second hand smoking outside be avoided completely or how much exposure could be considered okay?

Aaron Gilson, DO · Answer

Exposure to second-hand smoke can potentially impact the healing process after a fat transfer procedure. While direct effects on fat retention specific to passive smoking are not well-documented, it's known that smoking can impair blood flow and reduce the oxygen available to tissues, which is crucial for the survival of the transferred fat cells and overall healing. By 10-11 weeks post-op, your healing would be substantially advanced, but minimizing exposure to second-hand smoke, especially in enclosed spaces, remains advisable to support optimal healing outcomes. If you can, instead of cancelling your trip, try choosing environments with less smoke exposure.

Daniel Barrett, MD · Answer

Dear Graceful608697,
nicotine exposure can have a negative effect on surgery results so it is better to completely avoid it. I understand your concern. It is best that you consult your plastic surgeon regarding post operative care and management (i.e including massage techniques and timing) specific to your case. Your surgeon knows your condition well and has preferences on when and what to use for faster healing and recovery. Post operative care and management depends on the type of surgery performed and the technique used during surgery among other factors.It is best, however, that you follow your plastic surgeon's advice on post operative care management for a smooth and faster healing and recovery.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Smoking does affect others around the smoker. The biggest concern is if a smoker lives with you and smokes around you, especially in a car. Casual smokers that you might encounter in a bar should have little effect after a few weeks of healing.

Mats Hagstrom, MD (license on probation) · Answer

Cigarette smoke, can I have a detrimental effect on the outcome of certain plastic surgery procedures.
Not all plastic surgery procedures are affected the same way by cigarette smoking.
There are certain procedures that are very particular in regards to smoking creating high risk for complications.
I don’t think there is good published literature, and I don’t think anybody knows the actual impact of cigarette smoking on the outcome of fat grafting.
The procedures that are at highest risk for surgical complications in smokers are operations where tissue is moved and separated, creating a disruption in the blood flow(not grafted) 
These operations are typically facelift, tummy tucks, breast lift, and breast reductions. There are also a number of reconstructive options that involve creating flaps were smoking is known to increase complications dramatically
Operations like breast augmentation, eyelid surgery, or Liposuction does not have the same increased risk from smoking, though we generally recommend people always avoid tobacco use before, and after any surgical procedure.
We know that cigarette smoke has a negative effect on healing, but the extent of this can vary Substantially on what procedure is being performed.
I would prefer all my patients being non-smokers, but sometimes patients smoke and want surgery.
I generally have less concern for low risk procedures and am reluctant to do high risk procedures on active smokers.
There is very little evidence that secondhand smoke has any significant physiological impact on the recipient.
At 11 days, I don’t think nicotine is going to have an impact and I don’t think secondhand smoke would have any impact under any circumstance after plastic surgery. 
Of all the variables in involved that determine quality outcomes secondhand smoke is pretty low on my list.
I would definitely not forgo a vacation because you’re going to a restaurant where people are allowed to smoke.
Enjoy your trip.
Mats Hagström MD

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