pack a day smoker for 20 years, plan on mommy makeover in the spring. How long is recommended to quit smoking before surgery?

I would advise being off ALL forms of nicotine (gums, patches, lozenges) at least 4-6 weeks before AND after surgery.  The effects of nicotine on wound healing are significant!  For the best results and least risk of complications, PLEASE discontinue nicotine asap.

The sooner you quit before surgery the better.  Smokers have a higher risk of complications.  Smoking potentially puts you at a higher risk for general anesthesia as well as necrosis (or death) of tissue (skin).  Since blood flow is decreased healing can take longer as well as wound complications are increased.  I have all of my patients stop smoking for 1 month before surgery and following surgery.