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