I Smoked and my Surgery 2 Days Away! Reschedule?

I just read the section on smoking and feeling quite anxious now. I'm scheduled for surgery in 2 days and wondering if I should reschedule. Ironically, I workout 5-6 days@week, approximately 2-3 hours@day. Most of my workout routine is outdoors during the early morning hours (3-5am) and includes cycling(10-15miles), walking(5-10mi), stair climbing(20min). Indoors my routine includes yoga, tai chi, and strength training. Should I reschedule and clear my system?

Doctor Answers 13

Smoking and surgery


thanks for the post. Smoking is a strong risk factor to the success of your surgery. I generally recommend patients to eat healthy, take a multivitamin, and stay away from smoking at least a week before surgery. However, it's also important to avoid second hand smoke as the carbon monoxide is the prime issue that affects oxygenation of the tissues and quality wound healing. 

it's true that the half life of carbon monoxide is 80 minutes, however, from my  experience, patients who have ever smoked up to the day of surgery never heal as well as those who quit the week before. Some doctors will have different opinions about this, but it's VERY important to discuss this with your PS and make sure he /she is ok with this. 


Hope your procedure goes well regardless. 


Bennett Yang, MD

washington dc


Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

I Smoked and my Surgery 2 Days Away

Thanks for the question. Damages caused to body depends upon the extent of smoking and for the duration in years that one smoked. Surgery that has flaps like TT and Face lift are at a greater risk than surgeries that have no flaps like Breast augmentation. Breast reduction and a breast lift has a larger risk than .If you smoked few times the risk may not be as great as you think. However there are individual variations as how most PS take smoking and therefore its best to inform your PS. Wish you all the best.

Ashok Govila, FRCS, MCh, MS
Dubai Plastic Surgeon
4.7 out of 5 stars 88 reviews

Smoking? Your surgeon should know.

Some cosmetic procedures, tummy tuck and facelift, can be quite problematic for smokers. Other procedures such as breast augmentation or rhinoplasty, not so much so. Either way it is best  to let your surgeon know what you have been up to so he can advise you.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Smoking before surgery

It is true that smoking prior to surgery definitely increases risks related to the surgery. Having said this, the risks involved vary in nature and degree depending on the procedure. There are some higher risk procedures in my practice that I will not perform unless the  patient has quit smoking for several weeks. There are other procedures where the increased risk is minimal.

You should definitely mention your smoking to your surgeon and ask if it will significantly affect your surgery. Your surgeon is the best judge of the risks involved.

Eugene J. Sidoti, Jr., MD
Scarsdale Plastic Surgeon
4.7 out of 5 stars 3 reviews

Smoking and plastic surgery

You should notify your plastic surgeon today and ask this question immediately. Depending on the kind of surgery you are having, there can be serious consequences from smoking.  These surgeries where smoking is most dangerous are primarily tummy tucks, breast lifts and reductions, and facelifts.  But nicotine can affect healing in all surgery because of altered blood flow.

If your doctor warned you about this and gave you instructions to quit for a period of time before surgery, then you have not complied with instructions and it is not reasonable to put an unfillable hole in their OR schedule without financial penalty.   

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Smoking and surgery

I highly recommend you talk to your plastic surgeon about this immediately. Smoking increases your chances for surgical infections,risks, and complications.

Kiran Polavarapu, MD
Fort Worth Plastic Surgeon
5.0 out of 5 stars 42 reviews

I smoked and my surgery is 2 days away! Reschedule?

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!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Smoking and Surgery

Opinions regarding smoking and surgery vary widely.  Certainly certain procedures are riskier than others for those who smoke.  I look at the general health of the patient, the specific operation and how much the patient smokes.  For breast reduction, the technique selected is important, as is the length of flaps planned for the operation. Some would be riskier than others. Therefore, I take each situation on a case by case basis.  FYI: nicotine replacement therapy (ie. gum, patch, etc)  is not an option in any of these cases as their effect on blood supply can be even more significant.  I recommend calling your surgeon to discuss your specific scenario here. 

Ronald A. Lohner, MD
Philadelphia Plastic Surgeon
4.7 out of 5 stars 20 reviews

Smoking before surgery

Good question without an easy answer. Smoking can undoubtedly affect wound healing and some surgeries are more potentially affected than others. Discussion with your surgeon will help determine whether or not you need to postpone. 

Asaad H. Samra, MD
New Jersey Plastic Surgeon
5.0 out of 5 stars 40 reviews

Smoking and Breast Reduction

     I have not performed a breast reduction on a smoker.  Smoking does increase the risk for complications and compromises blood supply.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 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.