Does Smoking Increase the Chances of Staph Infection Following Bilateral Mastectomy?

Had a bilateral mastectomy 4/10/12 with expanders placed at the same time. Developed a severe staph infection in both breasts requiring 4 weeks of antibiotics. Left breast responded, but right breast did not. Had the right expander removed 6/25/12. Now I have a severe staph infection in left breast. PS says it is due to my smoking. I have had 8 surgeries (neck, hip, hernia, gastric bypass, etc) over the past 12 years and have NEVER had a staph infection. Is this due to the smoking or bad luck?

Doctor Answers 4

Does smoking increase the chances of Staph infection following bilateral mastectomy?

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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 mastectomy and reconstruction where the viability of the skin/tissue 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. you will likely never identify the true cause, but smoking certainly did not help.  Infections themselves are risk with any surgical procedure however.  Hope that this helps! Best wishes!

Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Does Smoking Increase the Chances of Staph Infection Following Bilateral Mastectomy?

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Complication rates in "flap" and "lift" surgery is greatly increased in smokers. This includes operations where a large area of skin is lifted off the underlying tissues--face lift, tummy tuck, breast lift, mastectomy.  The operation itself eliminated a lot of blood supply to the lifted skin. The nicotine further decreases blood supply by another mechanism, dramatically increasing wound healing complications. 

The other surgeries you have had would not have carried the same risks of inadequate blood supply. I think that smoking was the primary risk factor here. Best wishes . 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Smoking after Surgery

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In most cases there is no direct correlation between staph infection and smoking, but there is a correlation between wound healing and smoking. Usually the wound healing is decreased by 50%, therefore it increases the chances of an open wound. once an open wound occurs then chances of a staph infection is dramatically increased.

John S. Poser, MD
Gainesville Plastic Surgeon
3.8 out of 5 stars 11 reviews


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Smoking does not let your body heal at a normal rate. Having a foreign object and smoking is not a good combination. Your risks are higher then non smokers.

Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

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.