When can I start smoking after getting tissue expanders?

Question

Hello, I am planning on getting a breast reconstruction done. One of my breasts is genetically very small and I have to get a tissue expander before switching to implants in future. As far as I know i’m not to smoke cigarettes for at least 2 weeks after the operation. But is it ok if i smoke during the time i’m having the saline injection sessions? The injection sessions are scheduled to start 2 weeks after the surgery.

Ryan Rebowe, MD · Answer

In general, smoking cessation is recommended for the entirety of the time that you are having reconstruction. Smoking greatly increases your risk of having all complications including skin necrosis, infection, and need for revision. At the minimum you will have to stop smoking 6 weeks prior to each operation, and smoking within six weeks of your first tissue expander placement will still place you at risk for complications. Hopefully you can stop smoking all together, but at least stop smoking six weeks before and six weeks after your last operation.

Tommaso Addona, MD · Answer

Thank you for your consideration.
It is my recommendation to stay off of any nicotine products as long as you can. Products such as cigarettes and other nicotine based products can jeopardize wound healing and lead to infection, your incisions not healing, or losing the reconstruction entirely.

Derek Fletcher, MD · Answer

I strongly recommend patients avoid all nicotine products for 4 weeks before and 4 weeks after breast reconstruction surgery. In the time after surgery, the healing process is dependent upon blood supply at the capillary (blood-tissue interface) level. Nicotine causes these critically important blood vessels to constrict which will increase the risk of complications after surgery. These complications may include: nipple death, skin death, delayed healing, open wounds, failure of acellular dermal matrices (ex. AlloDerm) to incorporate, infection, and reconstruction failure. The power of nicotine to interrupt normal healing is predictable and unforgiving. If your goal is to minimize risk of major complications after surgery, don't use nicotine for at least 4 weeks.

Daniel Barrett, MD · Answer

Dear Riafthsu,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jayanthy Ravindran, MS, DNB, MRCS · Answer

It is very important to reduce your chances of infection, which is why you are asked to avoid smoking for as long as possible after the surgery. The best advice I can give you is to follow all of your surgeon's instructions carefully. Smoking will increase your risk of getting an infection, so it is probably best not to start smoking again until you have recovered completely from the tissue expander placement and are ready for the implant surgery. Your surgeon will be able to give you specific advice based on what they would like to do in your case.

Israel Manon, MD · Answer

Hello sweetheart!

The problem with smoking it's that nicotine sabotages plastic surgery due to vassels constrict making less blood flow to wounds and insition sites less oxygen means potential tissues death or necrosis.

Israel Mañon.

When can I start smoking after getting tissue expanders?

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