How Much of a Negative Effect Do Cigarettes Have on a Tummy Tuck or Butt Lift?

I'm 27 and I smoke about 10 cigarettes a day. With that in mind, would I not qualify for any major surgery such as tummy tuck or the butt lift? If so, how long would I have to quit in order to be qualified?

Doctor Answers 7

Smoking and Tummy Tuck

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The nicotine in cigarettes impairs the blood flow in small blood vessels in the skin which can result in skin necrosis (death) and wound separation.  This is particularly increased in procedures like a tummy tuck in which there are long incisions and big flaps of skin that are advanced into a new position.  The result could be unacceptable scarring and delayed healing requiring wound care.   

Additionally, the carbon monoxide in cigarettes inhibits the delivery of oxygen to the site of wound healing and further increases risks of delayed healing.  From an overall health standpoint, you will tolerate general anesthesia better if you have abstained from smoking, as well as decrease your risk of heart and lung disease.  Most surgeons recommend that you stop smoking (and avoid all nicotine containing products) 4-6 weeks before and after your surgery.  It can certainly be difficult to give up smoking so you may wish to talk to your primary care doctor about smoking cessation medications and support groups.  Good luck!

Cigarettes and Surgery

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Most doctors will not operate on you if you smoke.  There are serious consequences from smoking and having surgery... You have a substantially increased risk of infection and wound healing issues.  For a surgery such as tummy tuck, a wound healing issue or infection could be life altering.  It is my recommendation the that you be honest with your plastic surgeon about your smoking.  I recommend that my patients stop smoking for at least a month before surgery.


Good Luck.

Smoking and surgery

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Here are the major points of smoking Tobacco or Marijuana before or after surgery:
1. There is nicotine in tobacco, but not in marijuana. However, most joints are rolled with marijuana and tobacco combination. Nicotine is a vasoconstrictor that decreases blood flow to the tissues. This is the major problems that can cause a very bad outcome in some surgeries. In a breast augmentation, there is not a lot of risk as there are not a lot of incisions which decrease blood flow to the tissues. In a breast lift or tummy tuck, on the other hand, there is much longer and more involved incisions. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die. This can cause part of the breast or nipple, or in the case of a tummy tuck, part of the belly tissue to die, resulting in a very bad outcome. This is especially bad in breast reductions or face lifts. Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion. Vaporizers do not decrease the amount of nicotine in tobacco, only decrease the smoke. Hookah also does not decrease nicotine.
2. There is carbon monoxide in both tobacco smoke and marijuana smoke. Carbon monoxide decreases the oxygen carrying capacity of hemoglobin in the blood. This is different from the vasoconstrictor effect, but has the same result of having the risk of tissue death in conjunction with surgeries that decrease the blood flow to tissues such as breast lifts and tummy tucks, as opposed to an augmentation alone that does not decrease blood flow to as great of an extent. Again, edible forms of marijuana do not have smoke, and thus carbon monoxide poisoning.
3. Coughing. Both tobacco and marijuana smoke disrupt the lining of the lungs and bronchi and can lead to coughing episodes. Coughing episodes can lead to internal bleeding after surgery that can lead to hematomas and complications, and again a bad outcome. Again, edible forms of marijuana does not have this effect.
4. Anesthesia effects. Marijuana can have drug interactions with certain anesthetic drugs. Thus it is important to tell your anesthesiologist about your marijuana use.
In conclusion, Smoking, whether it be tobacco or marijuana, is detrimental to your surgery outcome. Edible marijuana is much less so, but be honest about your use with your surgeon and anesthesiologist so that you can have the best outcome. In general, you should quite smoking many weeks, ideally 6 weeks before surgery, and not smoke for at least 2 weeks after surgery.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

How Much of a Negative Effect Do Cigarettes Have on a Tummy Tuck or Butt Lift...

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Any procedure that requires an incision can be affected negatively by smoking.  Nicotine causes the small blood vessels throughout the body to constrict, limiting blood flow and compromising the healing of the incision. This is especially true for a tummy tuck because the blood flow to the skin in that area is not the greatest and tension is put on the incision during the closure.  You must stop smoking completely for one month prior to a tummy tuck.  If you don't, the incision can break down and it will take a long time to heal.  In general, it is vital to be honest with your surgeon to ensure a safe recovery.

Even 1 cigarette or second-hand smoke increases your risk of dead skin to as high as 15-20%! Just say NO to nicotine or tobacco!

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Most surgeons will not perform tummy tuck, breast lift, buttock lift, facelift, etc. on anyone who smokes or is exposed to second-hand smoke. I require a MINIMUM of 2 weeks; 4 is better, and even 1 cigarette is enough to vasoconstrict vessels and kill skin.

Once the skin is dead you cannot "revive" it by promising to not smoke any more! Too late! No kidding and no joke!

If I smell smoke on a patient scheduled for these procedures, I cancel surgery and refund their money (minus a cancellation fee). Even though it's THEIR dead skin, they expect ME to fix it, and that is impossible. You have to surgically debride the dead tissue, let things granulate and scar in by secondary intention over many weeks, and then after sufficient time to soften the scar (6-12 months) you can SOMETIMES re-operate and remove most of the scarring from this misadventure. Best avoided, as you might expect.

Just stop smoking now, (Using Chantix or Zyban is OK) save your money, and have a safe operation! Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Cigarette smoking and abdominoplasty

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One has to consider the general impact of smoking on one's health  (cardiovascular disease, lung disease, lung cancer etc.), as well as the significant impact of smoking on abdominoplasty.  Nicotine is a potent vasoconstrictor and can result in compromise of the blood supply to tissue following surgery.  This is particularly true for abdominoplasty.  Cessation of smoking for 4 weeks prior to, and 4 weeks after abdominoplasty would be mandatory.  

Glynn Bolitho, PhD, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Cigarette smoking and surgery

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Nicotine in cigarette smoke is very harmful to wound healing through a process of vasoconstriction.  This means that nicotine will not allow sufficient oxygen and nutrients to reach the surgical areas that need them the most and will therefore be detrimental to the healing process.  There are many studies that demonstrate the harmful effects of cigarette smoking on wound healing (in addition to its many other harmful effects).  It has been shown that avoiding nicotine for at least three weeks prior to surgery allows the normal wound healing process to take place.  Therefore, I have patients stop smoking (and avoid all nicotine products) for at least four weeks prior to breast lifts / tummy tucks / and brazilian buttock lifts.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.