Smoking and MM surgery; how is surgery impacted?

If a person is a smoker how is surgery impacted? Mm are very invasive I am aware. Also can the patient do smokeless remedies like patches ect if smoking is not allowed?

Doctor Answers 21


Smokers are about 13 times more likely to have MAJOR wound healing complications (not minor) as non-smokers in these operations. Things like nipple loss, skin loss, belly button loss are included. ALL smoke products (cigs/cigars/pipes/hookah/e-cigs) are included as are all nicotine containing substitutes (patches/gums/etc). We test patients' urine the morning of surgery for nicotine and will cancel the case (retaining pre-agreed upon cancellation fees) if it is postitive. If the patient does not care enough about their risks and results to stop for a few weeks before and after, we do not want to assume the risk of their lack of concern.

Smoking (even second-hand) is a serious issue in these cases and needs to be treated as such.

Miami Plastic Surgeon
4.5 out of 5 stars 69 reviews

Smoking and Mommy Makeover

I definitely agree with the others in stating that still smoking will leave you at much greater risk for post-op difficulties. It is always best before surgery to quit smoking for a significant amount of time, allowing the system to clear. The best recommendations would be from your own surgeon in order to specify what should be done in relation to your specific procedure.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Higher complication rates!

Smoking increases the risk of complications associated with surgery especially when skin flaps are raised. The micocirculation of skin is decreased as a result of the compounds in smoke. This increases wound healing problems, skin dying ( necrosis), higher infection rates, and anesthetic complications. You need to stop smoking several months before surgery. Your surgeon can check your urine right before surgery to make sure you have really stopped!

Michael S. Beckenstein, MD
Birmingham Plastic Surgeon
4.9 out of 5 stars 18 reviews

Mommy makeover & smoking

Thank you for your question.
Smoking is an absolute no when having this surgery.  You must stop smoking 4 weeks prior to surgery and 4 weeks after. This includes all nicotine products. Smoking interferes with the healing process and can cause you to have many complications. Please follow your surgeons guidelines on this. Best of luck.

Likelihood of MAJOR Complications with Smoking

Dear mzthng35,

Let me cut right to the quick. If you smoke and have a tummy tuck done you are most likely going to have a major complication with the skin and fat in your lower abdomen dying back and having to pack it with dressing changes for six to ten weeks before it closes finally. Though most surgeons blame the nicotine in these products, it is actually the carbon monoxide which is probably the worst effect as it binds to hemoglobin in your red blood cells far more readily than oxygen, so it displaces it. We ask our patients to quit smoking a minimum of one week before surgery and three weeks after. Nevertheless, even with compliance of these requirements there will still be an increased chance of wound complications with a history of smoking.

I hope this has been helpful.

Robert D. Wilcox, MD

Robert D. Wilcox, MD
Dallas Plastic Surgeon
4.1 out of 5 stars 13 reviews

Smoking Pre and Post Surgery

I would highly encourage discontinuing smoking of any sort at least 2-3 weeks prior and 3 weeks after your surgery as smokers are at higher risk for complications post surgery. Seeing as you are interested in the Mommy Makeover procedure I would highly recommend speaking to your PS about what their guidelines are for you. 

Smoking and Surgery

The issue with smoking around the time of surgery is not centered around the harmful habit of inhaling smoke which causes higher risk of lung disease, pneumonia and lack of mucus clearance as much as the nicotine circulating in the blood stream.  Any source of nicotine (cigarettes, smokeless tobacco, electronic cigarettes with nicotine, nicotine gum, nicotine patch) is a problem. Nicotine is a potent vasoconstrictor (shuts down tiny blood vessels) which are needed for healing.  This can cause disaster in the healing process of areas that had surgery. Some types of surgery are more risky than others such as surgery which involves moving large or low blood flow tissue planes. These procedures may already significantly reduce the blood supply to the healing wounds and adding nicotine is a double whammy causing the higher probability of healing problems.  Some of the more susceptible procedures are breast lift, breast reduction, tummy tuck, body lift and facelift. I require six weeks of smoking cessation before and after surgery and I test for nicotine just prior to going into the operating room.  If it is positive in risky cases, I cancel the surgery. Some patients desperate for surgery are not truthful about the use of nicotine or try to outsmart the surgeon by manipulating the urine specimen in some way. In the end, the real harm is to the patient. Loss of nipples, wound breakdown, and large areas of tissue loss can cause months of extra recovery, hospitalization, unsightly scars and the possible need for further surgery. Don't do it. 

Drew Schnitt, MD
Hollywood Plastic Surgeon
4.7 out of 5 stars 3 reviews

Smoking and MM surgery; how is surgery impacted?

We do not do Mommy Makeovers on patients who smoke, so to answer your question of how smoking impacts surgery, it simply takes the surgical option off the table. The significant risks are not worth taking for cosmetic surgery. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Mommy Makeover - Smoking?

  Thank you for your question. Smoking in the peri-operative period has been shown to result in a higher complication rate. I require my patients to stop smoking at least 4 weeks prior to surgery and not smoke for 4 weeks following the procedure. Please make sure you are cared for by a board certified plastic surgeon and have an honest discussion him or her regarding this. Hope this helps and good luck.

Smoking and MM surgery; how is surgery impacted

Thank you for your question.  Smoking will place you at a much higher risks of complications.  Any products with nicotine should be discontinued weeks before  a procedure, esp for facelift, breast lifts and tummy tucks.  Consult with a board certified Plastic Surgeon.  Best Wishes.

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.