Nicotine patch before breast augmentation?

Question

I quit smoking on December 14, 2017. I’ve been wearing the 14 mg nicotine patch ever since then. My breast augmentation surgery will be January 5, 2018 and by then I will be wearing the 8 mg nicotine patch by then. My surgeon will be doing the areola incisions. I am 26 years old and I don’t have any health problems. My surgeon says that I don’t need to stop wearing the patch, but I would like more input. Should I stop wearing the patch before my surgery? Thank you

Stephen T. Greenberg, MD, FACS · Answer

Nicotine causes vasoconstriction, causing the small blood vessels to constrict, or narrow, which eliminates proper blood flow to the healing areas that need it most. I recommend no nicotine about 4-6 weeks prior and well as post operatively to ensure the best healing with no wound healing issues.  All surgeons have different protocols and preferences, so make sure you consult once again with your Physician.Good luck and congrats on your upcoming procedure.

Christopher J. Davidson, MD, FACS · Answer

Thank you for your question.  Because nicotine causes vasoconstriction, nicotine in any form is not advised prior to surgery.  My advice is to speak with your plastic surgeon regarding your particular circumstances.  Good luck.

Aisha White, MD · Answer

I encourage you to eliminate all nicotine at least 2-4 weeks prior to surgery. Nicotine can reduce blood flow to surgical areas, thereby increasing risk of wound healing complications.

Ronald J. Edelson, MD · Answer

I have seen complications from someone using a nicotine patch after a face lift because it compromised the blood flow to the skin.  With a breast augmentation the risk is much lower but I would want you off the patch after surgery for at least a few days.

Richard Baxter, MD · Answer

The issue isn't the smoking specifically, it is the nicotine regardless of source. Nicotine constricts capillaries, reducing blood flow to the surgical site. Routine breast augmentation is low risk with nicotine exposure but when there is undermining and tightening - breast lifts, tummy tucks, and facelifts - there is a very real risk of severe healing problems.

Dallas Buchanan, MD · Answer

Thank you for your questions. My question to you is why would you willingly do anything that can increase your changes of complications? In my opinion, you should stop using all forms of nicotine (patches included) and delay your surgery until you have been off nicotine for 6 weeks. Why risk it?Best of luck!

Urmen Desai, MD, MPH, FACS · Answer

Every surgeon has his or her own rules.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Daniel Barrett, MD · Answer

Dear lovebritt91,every plastic surgeon has his own preoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Mark Deutsch, MD, FACS · Answer

I do not recommend any nicotine exposure prior to surgery. Nicotene exposure prior to surgery puts you at risk for wound breakdown and tissue necrosis and subsequent infection with possible loss of your implant.

Tim Sayed, MD, MBA, FACS · Answer

Nicotine poses a major risk to successful plastic surgery as it increased the potential for blood supply compromise, which can lead to wound healing problems, skin/tissue death (necrosis), and other issues. Additionally, nicotine increased blood clot, heart attack and stroke risks. Most surgeons recommend a MINIMUM of 14 days nicotine-free -- meaning NO nicotine patches, NO gum, NO vaping of nicotine, NO chewing tobacco, and of course NO smoking -- before elective surgery. It's even better if you can be abstinent for 4 weeks or more to bring your risk closer to the risks in nonsmokers. If you are having a breast lift at the same time I would strongly urge you to be nicotine free for 3 or more weeks. You need to check with your surgeon regarding specific guidelines about nicotine patches. Some surgeons would cancel surgery if you are not nicotine-free (which is testable with a urine test), but each practice has its own policies.

Nicotine patch before breast augmentation?

Answers (16)

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