How will my doctor know if I smoked cigarettes before surgery?

A test can be done to detect nicotine prior to surgery, but not all surgeons do this.  Please discuss this with your surgeon.  Smoking inhibits healing and can affect the final outcome.  Good luck.Sincerely,Dr. Michelle Spring

Hello and thank you for your recent question.  At this point your surgeon could test your blood to see if there is signs of smoking apparent but that is up to the surgeon.  Remember your surgeon wants you to stop smoking prior to surgery for your own benefit to heal properly with no complications.  Wish you the best!  

Hello and thank you for the question. We would not routinely check your blood/urine nicotine levels and just rely on your word. Having said that, you should be honest with your surgeon. Best,Pejman Aflaki, M.D.Johns Hopkins-trained plastic surgeon

Thank you for your question.  It is the official stance of the American Board of Plastic Surgery that elective cosmetic operations should not be performed on active smokers.  Nicotine causes constriction of the small blood vessels that supply all of the tissues, significantly impeding wound healing and ability to combat localized infection.  I recommend my patients who are smokers to refrain from any nicotine-containing products for 4 weeks before and 4 weeks after surgery.  Your surgeon may or may not order a blood test that will measure nicotine byproducts in your blood or urine, and may delay surgery if the test is positive.

When one smokes, or uses tobacco, there is vascular constriction. Nicotine is a major vasoconstrictor. There are others in tobacco as well. Good wound healing is all about getting enough blood supply to the area. The incision will also be put on some tension. Tension is the enemy of good wound healing, and coupled with decreased blood flow in smokers, finds the patient at higher risk of wound problems. Please stop smoking, (for dozens of reasons). If the prospect of your procedure is a motivation to quit, then so be it. Some doctors will test via urine or blood before the O.R.                   

Thank you for your question! There is a study you may be able to find online titled "Clearing the Smoke". It points out the risk of operating on smokers for elective surgery. A common rule is no smoking for 4 weeks before surgery and 4 weeks after surgery. It has also been studied that 28% of smokers will lie to their surgeon about their smoking status. Therefore, we routinely check for compliance with a cotinine lab test. This is done all for your safety, not to be judgemental. 

I never draw nicotine levels on my patients. I trust they would not want to sabotage their results by continuing to smoke. Wound dehiscence, infections, suture spitting, tissue death are all signs of smoking. Don't do this to yourself. Always be honest with your surgeon. We always want the best for you.Kind regards,Gary Horndeski M.D. 

Your doctor can check nicotine levels both in your blood and urine prior to surgery. If you have recently smoked, the nicotine will show up. While you may not want to postpone your surgery, it's always best to be honest with your surgeon because BOTH of you want the best possible result for you. Smoking, unfortunately, can have a very negative effect on your wound healing, resulting in a subpar result. Hope this helps!

Thank you for your question.   There are inexpensive urine tests that can be done in the office to determine if a patient is using nicotine products.  Not all surgeons use this test.  It is always best to be completely honest with your surgeon so they can provide you with and understanding of the risks and complications of proceeding with surgery if you are still smoking.  

Smoking can increase your risk of infection and slow the rate of your recovery. You are also at a higher risk of developing complications like necrosis. Your surgeon is protecting your safety by not proceeding with surgery if you've continued to smoke. You are the only person who will be hurt by hiding this.