How Long Before Surgery Should I Stop Nicotine Replacement Therapy?

Thank you for your question.  Congratulations on quitting smoking.  Nicotine causes constriction of the very small blood vessels which supply oxygen, nutrients, and healing factors to all of the tissues of the body.  The result of this is a significant impediment to the ability to heal wounds and fight local infection.  For this reason, it is the recommendation of the American Board of Plastic Surgery that patients stop all nicotine-containing products for at least 1 month before and 1 month following elective surgery.

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 or lozenge 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.

I applaud your efforts with stopping smoking.Your health overall will benefit from that
change! Unfortunately when we are worried about healing for surgery, the
nicotine is the problem.Nicotine causes
the tiny blood vessels in the skin and tissue to constrict, and this stops the
blood flow to the areas that are trying to heal.Without blood flow wounds just cannot heal
properly.Patients who smoke or use NRT
after surgery often experience delayed healing, wound breakdown, and end up
with worse scars and a less than optimal result.The most important time to be nicotine free
is from the date of surgery until about 3-4 weeks afterward, but given the
addictive nature of nicotine you will want to stop using NRT at least a few
weeks before that so that you are safely done by the time of surgery and not
tempted to cheat (and risk harming your results).It doesn’t usually work to quit cold turkey
the day of surgery… that would just add more stress for you while you are
trying to heal and recuperate from surgery!Also remember that second hand smoke can be just as dangerous to you as
you smoking yourself… so avoid second hand exposure for at least 3 weeks after
surgery too.Good luck with your
procedure.