Smoking and Scheduled for BA and BL 5/22/12. Am I Safe?

I will only have 11 days smoke free. I need to reschedule right??? I am so mad at myself, I could scream!!! I also have factor 5 leiden and prothrombin mutation.

Doctor Answers 21

Tell your surgeon

I generally recommend stopping smoking for 2 weeks before surgery. Smoking weakens your immune system and slows the healing process. However, because guidelines are different fro each surgeon, I would recommend asking your surgeon.

Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Smoking and scheduled for BA and BL 5/22/12. Am I safe?

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, poor scarring, and wound complications, as well as other health consequences. The anesthesia risk is greater with general anesthesia as well as pulmonary issues/lung infections postoperatively  as well as blood clots.  I would discuss this with your surgeon prior to your procedure.  Proper work-up and measures should be taken prior given your increased risk for blood clotting.  Hope that this helps! Best wishes!

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

Breast augmentation

I would not do your surgery!

In breast augmentation I have chosen to spend time reviewing photographs with patients to fully understand their expectation of size and shape. Many times this simply raises more questions. I will make measurements and use the implant guides to allow the patient to understand exactly the sizes that are reasonable for their body type and measurements.

Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!

Smoking and Breast Lift

I would reschedule your breast lift if you have smoked within three weeks of surgery.  Your chances of healing beautifully is much lower if you have been smoking.   Since cosmetic surgery is elective, why not offer yourself the best results?    

In addition, smoking increases coagulability, and if you have a hypercoagulable state, you increase your risks by doing surgery now.  Your doctor may also want to consider Xarelto or Lovenox 24 to 48 hours after your procedure.

Stephen Bresnick, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 32 reviews

Smoking plus Hypercoaguability = Russian Roulette

First of all, with your genetic tendency towards abnormal clotting - you need to stop smoking whether or not you have the surgery. Basically you have a disorder tha makes you hypercoaguable.That is, you have a  markedly increased risk for have a venous blood clot (deep venous thrombosis) that can travel to your lung (pulmonary embolus) - by smoking your are greatly increasing that risk even if you do not have surgery.  Here is another reason you should quit - you It has been estimated that the relative risk of capsular contracture  (abnormally hard and potentially distorted breasts) following smoking increases by up to  thirty times that of a non-smoker.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Smoking before Surgery

Smoking causes several complications for surgery patients. Generally, I wouldn't require patients to quit smoking for surgery, although they would have a smoother post op vourse if they do. I do require them to stop smoking at least 2 weeks prior to surgery and 2 weeks after. If you haven't been at least 2 weeks smoke free I would recomend taht you reschedule your surgery.

Howard N. Robinson, MD (retired)
Miami Plastic Surgeon
4.7 out of 5 stars 62 reviews

Smoking, Factor V Leiden mutation and breast surgery

Dear RNMommyof2,

Do you need to take Coumadin daily too ? Have you had any blood clots yet ? you do not provide much information...

If you were my patient, I would tell you your elective breast surgery can wait.

You should spend all your energy in trying to stop smoking before it seriously impairs your health with a DVT or even worse, a Pulmonary embolism. You are at a very high risk, and surgery is another added extra risk.

you need to be healthy for you and your children first.

once you can stop smoking permanently, you would need clearance from your hematologist too.

Good luck

Florence Mussat


Florence Mussat, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 44 reviews

Smoking and Surgery

Smoking increases the risk for surgery.The risk is greatest for individuals who are actively smoking but persists even in individuals who have stopped.

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

Smoking and breast augmentation/mastopexy

There is not yet a consensus on exactly how long you need to be smoke free to minimize your risk of problems with cosmetic surgery. But most studies that have been done to try to answer this question suggest waiting more than 11 days. In my practice, I would require 4 weeks smoke free and suggest at least 6 weeks before a breast lifting procedure. You probably could have the surgery without any problems, but there is no reason to increase your risks with an elective surgery. The factor 5 leiden mutation is another issue. There are different degrees of factor 5 leiden deficiencies, most of which are not a contraindication to this surgery, but should be discussed with your surgeon and possibly your hematologist. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 84 reviews

Nicotine use + Leiden Mutation + Breat Lift = Potential Surgical Disaster

We ALWAYS need to differentiate between NECESSARY surgery (surgery done to save lives or preserve function such as Mastectomy, Appendectomy, Coronary Bypass, Cancer Surgery) and Cosmetic Surgery (Surgery done SOLELY to improve appearance). This is NOT the same as ELECTIVE surgery (ANY surgery where we CHOOSE / elect the time of the surgery) , the opposite of which being EMERGECY Surgery (done whenever surgery cannot be delayed).

A Leiden mutation is associated with an increased risk of blood clotting in general, especially in smokers, the obese and in operations lasting more than 2 hours. Blood thinning medication is usually used to reduce such risks.

Nicotine is associated with a long-term fall in circulation in the skin. This can be associated with several healing complications and wound separation / death of the nipple complex in Breast Lift, especially when done together with a Breast Augmentation.

Personally, I prefer a MONTH free of Nicotine. Can you "get by" with less? Maybe. Is it really worth finding out? I would would reschedule the surgery.

Good Luck

Peter A Aldea, MD
Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 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.