most likely you're smoking did not have a dramatic impact on the survival of your fat graft. There's no question that smoking is very bad in regards to healing. There are a handful of procedures done in plastic surgery where smoking is disastrous. These are procedures when tissues are partially separated causing a compromise in their blood supply. In particular these include facelifts, tummy tucks, breast reductions and breast lifts. There are others but those are the most common. Heavy tobacco use after these procedures can lead to devastating complications including complication rates close to 50%. Other procedures such as breast augmentation or blepharoplasty smoking has virtually no impact. Fat transfer is something where blood supply is very important but the blood supply is not changed like in the above stated procedures. No one can tell you for sure exactly how much fat would have survived if you didn't smoke. There are too many variables including how much you were smoking etc. My best guess is high-volume fat transfer procedure in someone smoking two packs a day would probably cause at least a 50% decrease in fat survival. I would be much more concerned about your possible future lung cancer, emphysema, premature facial aging, cardiovascular disease including heart attacks, strokes and amputations then losing some of the grafted fat in your butt.Just my opinion. Smoking is a habit worth going to great links to give up. Millions of others have quit and so can you. Believe in yourself. Don't beat yourself up if it doesn't work the first time around. Just keep on walking down the path of a smoke-free world. Best, Mats Hagstrom MD
