How long will it take for nicotine/cotinine to get out of my system so I can pass the test?

Hi, thanks for your question. We typically recommend that you quit smoking at least 2 months before your surgery and for 2 months following your surgery. It's not really so much about passing a test, it's primarily about smoking inhibiting healing, and also about your lungs being irritated before you are put under general anesthesia. If your lungs and airway are irritated before you go under general anesthesia they could be overreactive and you risk going into what is called bronchoconstriction or simply put spasms. So you really want to be upfront with your surgeon about not only your smoking (how much you've smoked and when), but also about your alcohol consumption, which also has a bearing on the cocktail of drugs that you are administered before you go under. Please speak to you surgeon about this and any other concerns that you might have.

Hi & thanks for your question!
You should completely stop smoking 3 weeks prior to surgery. You may be okay with 2 weeks. Contact your surgeon regarding his or her guidelines regarding this. Best of luck!

“Pretty much quitting” smoking but still smoking half a pack for several days is not truly quitting smoking. If you are going to undergo an elective cosmetic surgery, which you are financially responsible for, it only makes sense to be sure that you are absolutely maximized to the best of your ability, so the risk of complications is minimized. That would mean no use of nicotine in any fashion: smoking, gum, lozenges, nasal spray, patch, etc, for a minimum of 3 weeks before your surgery. it would also be important to take into account the cumulative years that you have smoked because patients who have been heavy smokers for several decades have some underlying damage to their blood vessels. You should speak in detail about this with your plastic surgeon to determine the best way and safest way forward for you. Best wishes.

Thank you for your question. TBH, I'm not really sure how long you need to be nicotine free to pass "the test". However, that's not what you should really be worried about. Your main concern should be making sure your nicotine free for an adequate length of time for your surgery. The absolute minimum time you should be nicotine free before your surgery is two weeks, but longer would be safer. Nicotine is a very powerful vasoconstrictor (cuts off blood flow). That can mean the difference between a good result when you're nicotine free and an absolute disaster when you have nicotine in your system before surgery. By absolute disaster, I'm referring to your nipple turning black, dying and falling off. If this scares you a little bit, you should be. Being nicotine free for surgery is the one thing you can easily control to give yourself the best chance for a good outcome.
If you're trying to take it down to the wire just so you can pass the test, you're only cheating yourself (particularly your nipples and belly button).

I encourage you to speak to your surgeon openly and honestly about your nicotine use. Safety is the number one priority during surgery and you don't want to do anything to put yourself at higher risk. Nicotine can impede blood flow and put you at risk for complications during recovery. Decide together with your surgeon what is best for you based on your nicotine use and surgical plan.