Tummy Tuck Recovery While Being a Smoker, is This Okay?

Smoking brings a significant risk of cancer, stroke, heat attack, etc. From a Plastic Surgery standpoint it is a vasoconstrictor. Wound healing is all about getting oxygen and needed entities to the wound. It is well known that patient who smoke have a tremendous increase in their rate of serious complications, (infections, wounds falling apart, etc.). Nicotine is the main vasoconstrictor, so getting a patch or lozenge of nicotine won't help the vasoconstriction. Best to be off the tobacco/nicotine entirely before surgery. Please be honest with your Board Certified Plastic Surgeon. Together you can make a plan to quit and proceed with surgery. The amount of time between quitting and surgery will depend on the Plastic Surgeon and the procedure.

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 tummy tuck where the viability of the
skin/tissue, abdominal wall repair, and belly button 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 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!

Hi there-

It is very important, if you value your safety and the improvement in your body that you will get through a well-done tummy tuck, that you be completely nicotine free for at least 3-4 weeks before surgery and the same time period after.

If you do not abstain from all nicotine exposure for this time period, your risks of not looking your best, or worse, having a serious complication with un-planned medical care and expenses are dramatically increased.

The right thing to do is usually easier to understand than it is to do. But it's still the right thing. 

As with any surgery, especially if you are having a general anesthesia, smoking is not recommended. People who smoke have higher risk of complications after general anesthesia.

Smoking before and after a tummy tuck can definitely hinder your recovery. First of all, trying to cough after surgery is very difficult, and painful. If you have any type of cough following tummy tuck surgery the chances of damaging the repair is higher.

Secondly the blood supply to the incision is compromised in a smoker. The incision does not get significant oxygenated blood to aid in the healing process. The patient may experience breakdown of the incision. This can extend to loss of tissue and skin around the incision (gangrene) . The recovery period is extended and the patient may need to have additional surgery to repair the breakdown.

It is recommend that a patient try to stop smoking at least one month prior to surgery, and to not start again until healing is complete.

Smoking leads to decreased blood flow to the skin, During a tummy tucky your excess skin is cut away and the remaining skin edges are sutured together. The belly button is released and reattached through a new opening in the skin flap that is pulled down. Both the belly button and the skin that is pulled down to create a tight tummy are at risk to have poor blood flow when you are a smoker. The belly button can actually necrose and the wounds can have very delayed healing. Quit smoking at least 3 months before any surgery and also for your general health.

Thank you for your question. Many plastic surgeons, including me, will not perform a tummy tuck on someone while they are still smoking. It is too dangerous. The skin and fat on your tummy could die and turn black.  It's not worth the risk for an elective cosmetic procedure.

I will not do a full tummy tuck on a smoker unless they quit smoking three weeks before and three weeks after to prevent wound healing complications.

I will not perform any flap surgery on a patient that smokes. This would include tummy tucks, facelifts and breast lifts to name a few. You are at significant risk for wound healing problems including loss of skin which is very difficult to repair. I ask that all patients undergoing any of the above surgeries refrain from any nicotine products for 2-4 weeks before surgery and 3-4 weeks after. By that time, you are 5-8 weeks without smoking and hopefully you've "kicked the habit". Good luck.

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. This is especially bad in breast reductions or face lifts. In a rhinoplasty the tip of the nose and the columella, the area between the tip and the lip, is at risk. Your skin and tissue can turn black and fall off if this happens. 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. Hookah also does not decrease nicotine.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

I strongly advise my patients who are smokers to quit smoking for at least 6 weeks before and after a tummy tuck. Tobacco smoke interferes with wound healing and gives you a much higher chance of having a wound healing complication.  Why take the chance?  It's best to be honest with your plastic surgeon and do everything you can to maximize your chance of having a great result!