17 days pre-op - I smoked a cigarette. Am I going to be ok?

Question

Okay I was was drinking some wine with friends and I smoked a cigarette. My surgery is in 17 days. They will be testing for nicotine. Am i going to be ok? How can i flush my system of nicotine? If i test positive they will keep $2000 and cancel my procedure. Help!

Richard Baxter, MD · Answer

After two weeks or more your nicotine levels should be low enough to have the surgery safely but you should definitely let your surgeon know about it. I'm glad that you are taking the issue seriously, because the effects of nicotine on wound healing after procedures such as tummy tucks and breast lifts can be disastrous.

Alan Gonzalez, MD, FACS · Answer

Hello @Modest mama, thank you for your question. It is ideal to stop smoking at least one month before surgery. I suggest you consult with the doctor performing the surgery as the surgical technique varies from one doctor to another. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD FACS

Saad Alsubaie, MD, FACS, FRCSC · Answer

Smoking is really bad and can result in catastrophic outcome. I recommend rescheduling the procedure until you clear from smoking 6 weeks before and 6 weeks after.

Brian K. Reedy, MD · Answer

Hi & thanks for your question!
Call your plastic surgeon and let him/her know that you have smoked one cigarette. It is better to be honest and let them tell you if it will be okay.  It may be fine, but do not smoke anymore! Good luck!

Tommaso Addona, MD · Answer

Thank you for your question.
In my experience, I tell my patients to withhold from nicotine for one month prior to surgery to make sure they pass the nicotine test. The reason for this rule is to make sure that the blood supply is at its best as nicotine constricts it leading to increased risk of the wounds not healing. I would contact your surgeon and be honest about the cigarette.

George Bitar, MD · Answer

Each plastic surgeon will have their own preoperative protocol on nicotine usage.  It is meant to ensure that you have the safest surgery with the best outcome.  You are both on the same team, and there has to be trust on both sides.  You have to be honest with your surgeon and let them know as soon as possible.  I am sure that they will work with you on the pricing and schedule of your procedure.

Christopher Pannucci, MD, MS · Answer

Hi Modest,
Smoking is, unfortunately, one of the single worst things you can do around the time of elective surgery. Nicotine in even one cigarette will reliably squeeze down your blood vessels (this is also why it increases blood pressure ) for 1-2 hours--and these blood vessels are the ones that need to dilate to improve blood flow and allow healing to occur.
Patients who smoke are at much, much higher risk for surgical complications, most notably the potential for poor wound healing and infection. This is why most plastic surgeons won't offer elective procedures to smokers.
Will one cigarette 17 days post-op impact your healing? Probably not, to be honest. But the biggest issues you will face are:1. You may still test positive for nicotine (I have had people only exposed to secondhand smoke test positive) and2. If you test positive, your surgeon may not offer you an operation moving forward.
I know its not ideal, but I'd suggest coming clean with your surgeon in advance, so you and your surgeon are on the same page.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, WA

Leila Kasrai, MD, FRCSC · Answer

For your safety, please tell your surgeon. Each surgeon has their own pre-operative protocol and it’s best to inform them so that they can make the decision of what to do.

Warren Schutte, MD · Answer

If they are testing for Nicotine you will likely test positive before surgery, even with 1 use. I would be honest with your surgeon and ask that they postpone surgery for a few weeks. Literature shows that you should be nicotine free 4 weeks before and after surgery.

Daniel Barrett, MD · Answer

Dear Modest mama,
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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

17 days pre-op - I smoked a cigarette. Am I going to be ok?

Answers (15)

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