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

Doctor Answers 19

Smoking and tummy tuck recovery

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.

Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Smoking and surgery

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

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

Tummy tuck recovery while being a smoker, is this okay?

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!

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

Quit smoking before surgery

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!

James Knoetgen, III, MD
Fresno Plastic Surgeon
4.8 out of 5 stars 59 reviews

Nicotine Exposure of Any Kind is Dangerous with Tummy Tuck

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. 

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Tummy Tuck and Smokers!

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.

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

Smoking is always dangerous especially around surgeries.

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.

Laurie A. Casas, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 90 reviews

Smoking and a tummy tuck

Active smoking when undergoing a tummy tuck could be disastrous - resulting in loss (necrosis) of an extensive amount of tissue of the abdomen as well as other significant medical problems. This is the result of the nicotine causing narrowing of the blood vessels which means less blood supply and less oxygen and nutrition to the tissues.

Most plastic surgeons will require that you stop smoking for a period of time before and after surgery. The most common periods of time are 3 - 6 weeks both before and after tummy tuck surgery.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Tummy tuck and smoking don't mix

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.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews

Healing and Smoking do not mix

Smoking cigarettes is extremely detrimental to your health and will definetly shorten your lifespan.  You are inhaling into your lungs the waste products of leaves that contain compounds that will cause cancer.  In addition the chemical compounds (ie nicotine) cause permanent damage to the small and moderate size blood vessels in your body.  That is why cigarette smokers have such a high rate of heart attacks, the blood vessesl that keep the heart alive are damaged.  Do not have a tummy tuck if you are a smoker, you will not heal!!!!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 75 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.