Thank you for your question. Some of this may not be what you want to hear, but I am going to be honest with you. Insurance companies are required by law to cover breast reconstruction in cases of breast cancer, and this is not dependent on whether or not you smoke. The issue you are going to have to deal with is finding a surgeon who is willing to perform a breast reconstruction on you while you are actively smoking. While there are multiple type of breast reconstruction out there, in a general sense, smoking increases the risk of complications by up to 50% in some cases. Just think about the magnitude of that. If there is one single thing you can do to cut your risk of a complication in half, you would take that option right? So if that required quitting smoking, would it not be worth it? There is no other single factor that can have that big of an impact on your outcome. Certain types of reconstructions are safer in smokers than others, but as a general rule, I require all of my reconstruction patients to stop smoking for at least 6 weeks before and 6 weeks after surgery. Keep in mind, this is elective surgery, and you should be willing to do everything possible to maximize the chance of an excellent outcome for yourself and your chosen surgeon. I sincerely wish you the best in your endeavors and you deserve to have a breast reconstruction if you want one. I hope you will be willing to make a positive change for your health in the process. Best of luck to you!