Smoking increase the risks of poor wound healing and greater scarring if just a breast implant is done. In cases of a lift alone, the risks are much higher, and in combination of breast implants with a lift, the risk go even higher. I would not perform the combination on a patient unless he stopped smoking for one month before and one month after the surgery.
The Doctors Company a large insurer of Plastic surgeons has acknowledged for years that the cosmetic operation resulting in the highest number of unhappy women was a Breast Augmentation and a Lift done at the same time and worse, a te-do of one. A large number of these cases have to do with ugly scarring and implant mal position but many have to do with compromise of the blood supply in the breast skin created by the combination and portion of the skin dying and leading to exposure of the implants. This complication is much more common in people who use nicotine in any form and the repairs are costly and never yield an attractive breast. Instead of looking for either a stupid surgeon or an unethical one who would risk your future appearance for money, you should be thankful for the surgeons who took a loss and declined to operate on you and hurt you in the process. Get off nicotine for 2-3 months before surgery and you can have a reasonably safe operation with a good Plastic surgeon. You'll be glad you did.
Dr. Peter A. AldeaMemphis, TN
you have received good advice. Risk of wound healing problems or outright skin necrosis (skin death due to decreased blood supply which causes the skin to actually die) is SIGNIFICANTLY higher in smokers. This complication is reduced (but never eliminated) by quitting all nicotine products (cigarettes, vapor, nicotine gum or pills) for as long as possible prior to surgery. I insist on 2-6 weeks depending on the procedure. Some people lie of course and they are usually the ones whose wounds open up and have to heal in on their own. This compromises the end result...in other words your breasts will not look as good as they would have if there hadn't been problems healing. I suggest googling skin necrosis due to smoking at time of surgery so you can see for yourself. If you search tissue necrosis on this I am sure you can see some pictures. Best of luck. It will be worth it to quit!
In my practice, I ask patients to avoid nicotine in all its "modalities' of delivery 6 weeks prior to surgery. It is a powerful constrictor of blood vessels, decreasing blood flow to the “flaps” used during these procedures. This decreased blood flow could potentially lead to wound healing problems and/or tissue necrosis.
My best advice: avoid nicotine completely or avoid surgery.