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Effects Of Smoking Before & After In Plastic Surgery

Before crossing the threshold of the plastic surgery operating room, you have probably refrained from smoking for quite a few days, following your doctor’s advice. And you did right. Nicotine before or after plastic surgery is not a good idea. In this article, we’ll talk about the plastic surgery complications caused by nicotine and offer cosmetic surgery candidates some helpful advice on how to facilitate a safe and speedy recovery.

woman smoking

What Products Contain Nicotine?

Nicotine is not just hidden in the smoke of cigarettes. It can take several forms, like smoking substitutes that might seem harmless, but they are not. Here’s a list of popular products – in addition to common cigarettes – that contain nicotine:

  • E-cigarettes
  • Nicotine Gum
  • Chewing tobacco
  • Pipes
  • Cigars
  • Nicotine Patches
  • Smokeless Tobacco (Snuff)

Complications of Nicotine Use Before Plastic Surgery

Not all medical surgeries are the same. You might have had an appendectomy or a knee surgery a few years ago and have healed greatly, even though you were smoking before the procedure.

However, cosmetic surgery is different. The most important problem caused by nicotine intake before plastic surgery is tissue necrosis.

During cosmetic surgery procedures, the surgeon performs lateral incisions, cutting through the top layer of the skin. The sidewise incisions allow for more accurate and efficient tissue repositioning. Thus, when the surgeon lifts the top skin layer, he/she can pull it, stretch it, move it around or remove it completely. This is the method for performing a facelift, a tummy tuck, a breast reduction, or a breast lift. These incisions sever the end of blood vessels – a relatively safe process when vessels are healthy. But how healthy are smokers’ blood vessels?

Nicotine reduces blood flow, restricts circulation, and limits oxygen transfer to tissue. Add the cut of vessels and the subsequent limited blood supply in a surgical site, and you can now understand how easy it is for skin, fat and muscle to die without proper blood circulation and oxygen. This is called tissue necrosis and requires the removal of skin and other tissues around the incision site. If tissue necrosis occurs after breast augmentation, breast implants should be also removed.

So, nicotine means small blood vessels. Small blood vessels mean less blood circulation. Less blood circulation means less oxygen. And, finally, less oxygen can lead to tissues dying.

Other Complications Caused By Nicotine

Nicotine before or after plastic surgery can result in other problems, too:

  • Infections
  • Fat cells death (fat necrosis) that causes hard lumps
  • Loss of nipples, tummy skin or cheek skin after a breast lift, breast reduction, tummy tuck surgery or facelift, respectively
  • Slow healing
  • Permanent vessel damage
  • Unsuccessful breast augmentation – loss of breast implants
  • Thick, visible scars
  • Blood clots that can lead to death
  • Unbearable pain
  • Low immunity
  • Stroke, blood clots, deep vein thrombosis (DVT risk), heart attack, pneumonia, and other life-threatening complications.

How Long Do You Have To Stop Smoking For Plastic Surgery?

If you smoke, vape or use any other nicotine products and have scheduled a plastic surgery, you need to quit at least three to six weeks before the operation. Your plastic surgeon will let you know the exact time you must be nicotine-free before the cosmetic surgery.

Secondary smoke, for example, sitting next to someone who smokes, or sharing your room with an active smoker, is not a good idea either. Even one puff will make your blood vessels shrink.

If you have less than two weeks until the plastic surgery, confess to your doctor and reschedule the surgery for a later time. Do not put your health at risk!

After surgery, the suggested period of refraining from nicotine use is at least two weeks. This way, you increase the chances for a speedy and successful recovery.

How to Quit Smoking Before Your Plastic Surgery?

We know that it is hard for most smokers to quit nicotine use from one day to the other. Nicotine products are highly addictive. Here are some tips to facilitate nicotine quitting:

  • Focus on your hobbies & activities and keep yourself busy.
  • Download an app that helps quit nicotine, manage cravings and monitor your progress.
  • Spend time with non-smoking friends and family members.
  • Ask friends and family not to smoke in your presence.
  • Change your routine – join a yoga class or take time to walk.
  • Hide all ashtrays and throw away any nicotine products you have in your bags, car, or at home.

Can smoking increase the risk of complications during and after surgery?

Smoking poses significant risks during and after plastic surgery procedures. The nicotine present in cigarettes causes blood vessels to constrict, leading to reduced blood flow and oxygen supply to tissues. This can result in delayed healing, increased susceptibility to infections, and even tissue death (necrosis). 

Smokers are more likely to experience slower wound healing, heightened risk of infection, pronounced scarring, and poor skin quality following plastic surgery. Quitting smoking prior to and after the procedure is crucial to minimize these risks and optimize surgical outcomes. 

Nicotine replacement therapy and support programs can be helpful tools for those trying to quit smoking, improving overall healing and reducing complications.

Are there any specific plastic surgery procedures that are more affected by smoking?

All surgical procedures can be affected by smoking. For patients considering breast reduction or breast lift, quitting smoking is essential before and after the procedure, according to the doctor’s recommendations. 

Smokers undergoing these surgeries face a greater risk of compromised blood supply to the nipples, which can result in nipple loss or necrosis. The constricting effects of nicotine on blood vessels can significantly reduce blood flow to the nipple area, leading to potential complications. 

It is crucial for individuals considering having plastic surgery to quit smoking well in advance to enhance blood circulation and ensure optimal healing outcomes. 

Can nicotine replacement therapy be used as an alternative to quitting smoking?

Nicotine replacement therapy (NRT) is a valuable treatment option for individuals aiming to quit smoking. NRT involves the use of products that provide controlled and reduced doses of nicotine without the harmful toxins found in cigarette smoke. These products, such as nicotine patches, gum, or inhalers, help manage nicotine cravings and alleviate withdrawal symptoms, supporting the quitting process. 

NRT can be an effective alternative to smoking, aiding in the “quitting smoking” journey and minimizing the risks associated with nicotine use during and after plastic surgery procedures. It is essential to consult with healthcare professionals or smoking cessation specialists to determine the most suitable approach for quitting smoking and incorporating NRT as part of a comprehensive cessation plan.

Do all plastic surgeons test for nicotine?

Plastic surgeons require patients to abstain from smoking for a specific duration before and after surgery. Some surgeons may even conduct urine tests to detect nicotine levels on the day of the procedure. These measures are in place to ensure patient safety and optimize surgical outcomes. 

By testing for nicotine, plastic surgeons can identify patients at a higher risk of complications and take appropriate precautions. It is essential for patients to disclose their smoking habits truthfully and adhere to the surgeon’s instructions regarding refraining from smoking to minimize potential risks associated with smoking during the surgical process.

What happens if you test positive for nicotine before surgery?

In the event of testing positive for nicotine before surgery, the plastic surgeon may cancel the scheduled procedure. This precaution is taken because nicotine causes vasoconstriction, narrowing the blood vessels and impairing proper blood flow to injured tissues. 

Adequate blood circulation is crucial for optimal healing and minimizing the risk of complications. Testing positive for nicotine indicates recent smoking or nicotine use, which increases the likelihood of adverse surgical outcomes. 

To proceed with the surgery safely, patients must demonstrate a commitment to quitting smoking and follow the surgeon’s guidelines for a designated period before rescheduling the procedure.

Make An Appointment With Dr. Stavrou in Nicosia, Greece & Malta

Experience the confidence of being in expert hands that will make you look and feel more beautiful than ever. Book an appointment with our experienced and board-certified plastic surgeon in Cyprus, Athens and Malta, Dr. Stavrou. He will answer all your questions and concerns about smoking before or after cosmetic surgery, and ensure a safe and successful procedure.

Do you want more information? Read our article about all the plastic surgery myths.


Dr Stavrou is a board-certified and highly experienced plastic surgeon in Cyprus, Greece and Malta, with a keen interest in informing patients about the latest updates on reconstructive and cosmetic plastic surgery.

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