Is It Safe to Having Cosmetic Surgery if You Smoke Rarely?

By the time I will have a tummy tuck/breast lift, I will be almost smoke-free for a month. I smoke 1-2 cigarettes per WEEK. Are my risks similar to that of a non-smoker since I smoke so rarely, or am I still at an increased risk? I'm most concerned with necrosis...

Doctor Answers 17

Is it safe to have cosmetic surgery if you smoke rarely?

Hello! Thank you for your question! The issue with nicotine is that it also acts as a vasoconstrictor, clamping down of blood vessels. Blood supply is always of great concern during any surgical procedure, but especially in surgical procedures where the viability of the skin/tissue is obviously important. Since the vascularity to the area is already tenuous since it will be raised by cutting around the area, maximizing blood flow to the tissue is critical.

Typically, we recommend at least 6 weeks of smoking cessation prior to and at least 6 weeks after any surgical procedure. The longer, the better. Nicotine always increases the risk for infection, nipple necrosis, poor scarring, and wound complications, as well as other health consequences including blood clots. The anesthesia risk is greater with general anesthesia as well as pulmonary issues/lung infections postoperatively. I would discuss this with your surgeon prior to your procedure. Hope that this helps! Best wishes!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 17 reviews

Smoking and Elective Cosmetic Surgery

Remember this is elective cosmetic surgery.   In addition to medical risk, there is a financial risk.    You want to minimize both of these.   Wound complications can add weeks to months of recovery time.     With a combined breast lift and tummy tuck, i would take every precaution to minimize your chance of wound healing issues.   I would recommend having time on your side and waiting a full 6 weeks before surgery and at least 1 month after surgery.   You will still carry a higher risk than a non smoker, but this length of time can substantially decrease your risk of problems.   I wish you a safe and healthy recovery.  

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 75 reviews

Smoking and cosmetic surgery Mastopexy

Smoking increass of having complications with any type of surgery. Smoking causes vascular constriction which decreases the blood supply to tissues including skin flaps in the heart. Smoking also causes long-term damage to the blood vessels.

When you stop smoking for 3 or 4 weeks prior to surgery you can get a reversal of the vessel constriction. The long-term damage cigarettes cause will still be present. Smoking a single cigarette will cause the blood vessels constriction and decreased blood supply to the tissue including the heart and skin. This effect will last for 2 more weeks after single cigarette.

It is always safer for you not to smoke in all prior to surgery.

Wendell Perry, MD
Miami Plastic Surgeon
5.0 out of 5 stars 208 reviews

Safety in Cosmetic Plastic Surgery #mommymakeover, #tummytuck, #breastlift, #breastaugmentation

Dear Steffi2618

For optimal results in surgery- it is best not to smoke..... and !!!! for your skin and health it is best not to smoke!  Smoking does not preclude you from being a surgical candidate but it does increase your risk of recovery delay and compications!

With Warm Regards,

Trevor M  Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 86 reviews

Smoking does not fit well with many Plastic Surgeries

Tummy Tucks, Breast Lifts, Facelifts and smoking are MISFITS.  

Even an ex-smoker has higher risks compared to a non-smoker.

 Personally, I am comfortable operating after 4 weeks of TOTAL ABSTAINANCE from smoking.  However, I am not opposed to a longer smoke free period.  However, risks are always higher even in an ex-smoker compared to a non smoker for all of above surgeries. 

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 20 reviews


any smoking increases the risks during surgery, however the more you smoke the greater the risk.


Jay M. Pensler, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 14 reviews

Smoking Causes Complications with Wound Healing

The nicotine in cigarettes cause small vessels to go into spasm. Many plastic surgical procedures rely on capillary fill to deliver oxygenated blood to the healing area. Decreased  blood supply can cause poor healing, wound infection and in worse case scenario, tissue loss. The longer you are off nicotine (including nicotine patches), the safer the surgery. If you have only recently stopped smolking and your surgeon and you choose to go ahead with surgery, it may be necessary to alter the surgery so that there is less risk with blood supply. We refer to this as the beauty- blood supply barrier. In other words your surgeon might need to compromise on beauty so as not to increase risk.

Mary Lee Peters, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 106 reviews

Stop smoking completely

All surgical procedures have risks and no reputable experienced plastic  surgeon Will tell you that you cannot have complications. Smoking at any level increases the risk of wound healing problems. You are down to 1-2 cigarettes per day and paying a significant amount of money for cosmetic surgery. You want the best result as does your surgeon. Go the extra step and stop smoking for a month before and after surgery. You Will be glad you did.

Richard Linderman, MD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 9 reviews

Smoking and surgery risks

Smoking any number of cigartettes carries a higher risk of skin necrosis. Stopping smoking is said to help, the risk remain. I agress with everthing said here especially about stopping smoking 4-6 weeks prior to surgery. And it would be even better if you do not smoke after surgery.  Good luck

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Smoking and cosmetic surgery

Smoking in any form is no good for wound healing and can cause multiple problems and complications in surgery.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 23 reviews

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.