Smoking Before Breast Lift?

I am scheduled for a breast lift on May 21. When I went to the doctor in March he told me I needed to be cigarette-free for 4 weeks before surgery. So, about 5 weeks ago I went from about 14-15 cigarettes a day to about 1 per day. This past week I went from 1 to nothing. Should I be ok for surgery in 1.5 weeks?

Doctor Answers 15

Smoking before a breast lift, a bad idea.

Using tobacco products 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 patients 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. A breast lift by definition places the wound on tension. Tension is also a risk factor for wounds. Please be honest with your Board Certified Plastic Surgeon. Together you can make a plan. The amount of time to be nicotine free, (before and after the surgery), will depend on the procedure and the individual surgeon.


Las Vegas Plastic Surgeon
4.5 out of 5 stars 15 reviews

Smoking and BA

Most experts unanimously agree that smoking increases the rate of breast augmentation surgical complications significantly. 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.
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.
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.
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.

Smoking and Breast Lift

All surgical procedures carry some degree of risk, and smoking before or after surgery can increase the potential for any risks. Occasionally, minor complications occur and do not affect the surgical outcome. Major complications associated with this procedure are rare. The suitability of the breast lift procedure and specific risks may be determined during your consultation.

With the including of smoking at only 1.5 weeks before surgery you may want to discuss post-op healing potential with your PS before your procedure. Best of luck!

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 93 reviews

Smoking and breast lift

Thank you for your question. Smoking before or after your surgery can increase your risk of developing complications including infection and wound healing problems. I tell my patients that it is ideal to stop a couple months ahead of surgery and then for a couple months after surgery.  With your reduction, you have lowered your risk, but will still carry some additional risk.

Talk to your surgeon, especially about the pain you're feeling

Smoking is very detrimental to the recovery process following breast lift and other surgery. It compromises your immune system making your body less effective in fighting infection. It also hinders circulation making the recovery process slower. I usually recommend my patients stop smoking about four weeks before surgery. However, if you were smoke-free for three and only smoked one cigarette, you may be okay. Please ask your surgeon for their advice.

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. 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 40 reviews

Smoking before breast lift?

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 any surgical procedure. 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 22 reviews

Stop smoking before and after a breast lift

You just never completely know about healing in smokers.  If you have been off smoking for 4 weeks prior to surgery we believe that the risks do go down.  Continue to smoke after surgery and you are asking for wound healing problems.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 15 reviews

Smoking before elective surgery - bad idea

Every surgeon has their smoking cessation protocol.  Please talk to your surgeon and be honest about your tobacco/cigarette use.  Best of luck!

Dr. Basu

Houston, TX

Smoking and breast lift

Every surgeon should have  a policy on smoking and elective surgery. You need to be honest with yours and make sure that he/she is comfortable continuing with your procedure. Even though the odds are that you would have no problems with the surgery, there really is no reason to take a risk. I would suggest postponing the surgery until you were able to be compliant with your surgeon's policy. 

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 76 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.