Smoking Only 2-3 a Day, Can It Affect Your Healing Process So Bad?

Im going for a breast lift and tummy tuck and fix of inverted nipples.... I'll be going the 13th of July. I'm a social smoker, I'm drinking diet pills and then instead of eating Ill smoke.... ok I know its not healty, but by smoking lets say 10 per week, will it make such a big difference??

Doctor Answers 23

Smoking and plastic surgery

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I advise all patients to discontinue smoking prior to surgery.  That said, smoking is especially dangerous and should be avoided for at least two weeks for patients undergoing tummy tuck and breast lift (mastopexy). Both of these procedures can compromise blood flow to the operative area following surgery.  Smoking causes vasoconstriction which could further compromise blood flow to these areas.  The dangers are real and patients risk skin loss and infection when they continue to smoke prior to these procedures.  Even a few cigarettes per day can affect healing.  Diet pills should also be discontinued as they may increase your heart rate prior to and during surgery.

Avoid smoking for at least 2 weeks before plastic surgery

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Smoking can have disastrous effects on wound healing, both at your breasts and abdomen. You should refrain from all smoking (and nicotine) for at least 2 weeks, preferably longer, to minimize your wound healing complications. You should also stop your diet pills for about two weeks before surgery as well.

Discuss this in greater detail with your plastic surgeon prior to surgery.

Best wishes,


William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 410 reviews

Breast Augmentation - Smoking, Breast Lift, Tummy Tuck...BAD Idea...

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Hi Rese,

Big difference?   Maybe not...but if the answer is yes, it could be a total disaster!

Actually, of course, there's no way to answer a question such as this with absolute certainty.  There are no guarantees, and no assurances, despite everyone's best intentions.  But what is sure is that all you can do is try to tip the scales in your favor:  do everything you can that can help, and as little as possible that could hurt. 

And in THAT category, smoking is one of the most dangerous things you could be doing to yourself.  Aside from long-term problems such as cancer, heart attacks, strokes etc., and less significant issues like more facial lines, discolored fingernails, there is a clear correlation between smoking and an increase risk of wound healing problems, flap necrosis, delayed healing and widened scars.  This is particularly true for the procedures you're having.

The question really is:  how long do you have to stop smoking before the risks go down?  And there's no answer to that, either.  The small blood vessel disease is there for long after you've stopped...but it increases your risks exponentially if you keep smoking.

Big difference?  I would say so...

I hope that this helps, and good luck,

Dr. E

I Do Not Perform Elective Cosmetic Surgery on Active Smokers

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Thank you for your question. I do not perform elective cosmetic surgery on active smokers, and it is the position of the American Board of Plastic Surgery not to as well. I recommend patients stop smoking 1 month before surgery and do not restart until 1 month after surgery. It's the nicotine that is the problem, so a nicotine patch will not help. Nicotine constricts flow of the microvasculature (small blood vessels) and impedes healing. 

Smoking and Diet Pills

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Thank you for your question.  In short, smoking even a single cigarette in the immediate pre- and post-op period can have huge effects on how you will heal following your breast lift and abdominoplasty surgery.  Smoking, especially nicotine products, can increase your risks for infection, wound formation, wound healing, skin necrosis, poor scarring, seroma, and scar tissue formation following your procedures, as it constricts the small blood vessels that deliver oxygenated blood to your tissues.  In an effort to promote the best healing possible, I recommend that my patients discontinue smoking and the use of nicotine containing products at least 4-6 weeks pre- and post-operatively.  I also ask that my patients discontinue the use of diet pills and supplements for at least 2 weeks pre- and post-op as well, as these products can interfere with heart rate management and specific anesthetics and pain management used.  Please discuss your current use of diet pills and smoking with your operating surgeon before surgery.  

Smoking greatly impacts oxygen delivery!

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It’s not unusual for cosmetic surgery patients to smoke cigarettes.When patients smoke cigarettes, they have an increased rate of complications.This occurs for several reasons including constriction of blood vessels and decreased oxygen carrying capacity of red blood cells.This can result in decreased blood flow and decreased oxygen delivery to the skin and subcutaneous tissue.Unfortunately, this may occur when patients smoke only 2 to 3 cigarettes per day.
Patients who smoke cigarettes have a higher incidence of wound breakdowns, open wounds, tissue necrosis, infection and scarring.For these reasons, surgeons are very cautious when treating patients who smoke cigarettes or use nicotine products.
The risk varies with the type of procedure performed.Procedures that involve extensive undermining of skin such as facelifts, abdominoplasty, breast reduction and breast lift are associated with high complication rates.
In an effort to minimize complications associated with cigarette smoking, we recommend not smoking for 4-6 weeks prior to surgery.We also recommend not smoking for at least one month following surgery.This approach is modified based on the type of procedure performed.
If you have questions regarding cigarette smoking and your surgery, make sure you discuss them with your surgeon.Your surgeon should be able to discuss your risk factors.

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. 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.
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

Smoking only 2-3/day. Can it affect your healing process so bad?

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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 such a procedure as a mastopexy where the viability of the nipple-areolar complex 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, and wound complications, as well as other health consequences. 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 28 reviews

No Smoking Before and After Tummy Tuck and Breast Lift

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Cigarette smoke can compromise a patient's recovery because it makes the body weaker against infection and delays wound healing.

I recommend that patients stop smoking four weeks prior to their aesthetic surgery. This is particularly critical with respect to procedures that involve manipulating the blood flow to tissues, such as a tummy tuck and breast lift. I feel so strongly about this that I recommend you do not proceed with the above surgeries if you can't stop smoking for the recommended four weeks. It's just not worth it.  

Social Smoking is Bad for Surgery

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Most experts unanimously agree that smoking increases the rate of  breast augmentation surgical complications significantly. The more you smoke the more likely you will have problems starting with second hand smoke or just a few cigarettes per day. Just about all plastic surgeons strongly recommend  women  to stop smoking and all nicotine products well in advance of breast augmentation with breast implants.  Many plastic surgeons recommend stopping all tobacco products several months prior to surgery.A scientific article in the Archives of Internal Medicine indicated that, among all forms of surgery, quitting smoking eight weeks prior was never associated with an increased risk of complications.

Here is the reason why: the nicotine in cigarettes and other tobacco products (including Nicorette gum, patches, etc) is a vasoconstrictor, meaning it makes the Smoking is a significant multiplier of many potential complications following surgery and breast augmentation with implants are no exception. Nicotine from smoking causes blood vessels to vasoconstrict ( tighten up). Over time, these constricted arteries and capillaries deliver less blood to the breast tissue which is needed for normal healing. Smokers therefore have an increased incidence of higher likelihood of complications such as infection, and in particular capsular contracture (hardening and distortion of the implants). General complications of surgery such as blood clots, anesthetic problems such as pneumonia are also increased. For a tummy tuck there is increased likelihood of both an infection and loss of skin because of inadequate circulation.

In young patients you will probably statistically avoid these complications, why tempt fate by increasing your odds that something bad will happen. .On a long term basis, smoking also causes accelerated aging of the skin and loss of elasticity. Hopefully these reasons will help give you the will power and courage to stop smoking.


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.