How Long Before Surgery Should I Stop Nicotine Replacement Therapy?

Since you asked the question, you must be aware that smoking increases the risk of some complications for surgery including wound healing. Congratulations on quitting almost a year ago! Available evidence does not support a detrimental effect of NRT in surgical patients, especially when compared with the consequences of continued smoking. However, I advise my patients not to take anything other than vitamins prior to surgery. I like to see them avoid anything unnecessary for two weeks before and two weeks after surgery. Good luck.

 

Thank you for bringing up this so very important topic.  Nicotine is vasoconstrictor- like a chemical/drug tourniquet on the tissues.  That prevents normal blood circulation from reaching the surgical site.  Oxygen, nutrients, antibiotics and healing factors are reduced with nicotine present (from any source).  I advise my patients to be off all forms before and after surgery until fully healed.  For those who quit smoking and ALL sources of nicotine (gum, lozenges, patches, vape, e-cig, etc.), I regularly do a urine test in the office that detects the presence of nicotine metabolite to maximize healing success.  1 cigarette can stay in someone's system for a much longer than some might believe.  Great job quitting!  Talk with your local board certified plastic surgeon about your specifics!  Best Wishes!

Nicotine causes vasoconstriction of blood vessels in healing tissues which can cause a breakdown of incisions leading to open wounds. You literally risk major infections, tissue loss, and scarred distortion of normal anatomy. Not to mention smoking causes the release of millions of free radicals that cause intense inflammation and destruction to healthy tissues. I require my patients to stop all nicotine 2-3 months before surgery.

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.