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When Should I Quit Smoking Before Plastic Surgery?

If you’ve ever had a consultation for surgery, you’ve likely heard your surgeon tell you you’ll need to quit smoking. This is NOT just a suggestion or a surgeon’s individual preference; it’s an important factor that protects you and improves almost every aspect of your surgical experience. Smoking can have a big impact on your surgical outcome, results, and comfort throughout the surgical process. But how does smoking impact surgery, and when do you need to quit? Here’s everything you need to know about the interactions between smoking and plastic surgery.

When do I have to quit smoking before plastic surgery?

We ask patients to quit smoking two months prior to surgery. The earlier you quit, the more positive the impact—quitting two months in advance has markedly better outcomes than quitting a few days beforehand. 

Here’s a breakdown of how the cessation of smoking affects your surgical outcome when you quit two months beforehand:

  • Results in more optimal blood pressure, heart rate, and enhanced tissue oxygen concentration.
  • Helps prevent breathing problems and other complications during surgery.
  • Improves your body’s capacity for proper wound healing and lowers your risk of post-surgery infection.
  • Lowers your risk of blood clots, heart attacks, and infection. 
  • Anesthesia works better and immunity is improved to help fend off sickness or healing complications. 
  • Improved scar healing and less noticeable scarring, and improved pain tolerance or discomfort. 

What are the risks of smoking up until my surgery?

Smoking increases your chances of surgical site infection, wound dehiscence (re-separation of the incision due to improper healing), and in the case of reconstructive surgery, tissue death (necrosis)1. One study found that patients who underwent breast augmentation with implants had a statistically significant higher rate of wound complications if they were smokers within a year prior to surgery versus those who were not.

What about smoking after my surgery?

If you abstain from smoking after your surgery, you’ll improve your healing time and signs of scarring, lower risk of complications relating to circulation or infection, and also lower the risk of illness like pneumonia. You’ll also have a speedier recovery time, which means you’ll get to enjoy the results sooner.

Is it okay to replace smoking with aids like nicotine gum?

Quitting completely and avoiding nicotine is ideal for a safe and healthy surgery. Nicotine is the culprit for many of the side effects and negative outcomes above. If you’re having difficulty quitting, it’s tempting to use nicotine patches. But patches still contain nicotine, which is responsible for many of the side effects that negatively impact your surgery and healing. Patches, gum, chewing tobacco, cigarettes, cigars, and Juuls or other vaping devices can all contain nicotine and tobacco––so make sure you understand the fine print of whatever you’re using to replace cigarettes. So much of this is individualized to the procedure and the patient. Our team is always happy to discuss this further with you.

What about marijuana without tobacco in it?

The biggest conflict with marijuana smokers and surgery is the way it interacts with anesthesia. It has been shown that marijuana smokers require a higher dose of certain commonly used anesthetics. If you’re nervous about surgery and use marijuana to relax, it might be tempting to use it before surgery. But doing so can have consequences and can make your surgery or anesthetic more complicated.

Here are some other interaction difficulties with marijuana and surgery:

  • Marijuana smokers experience a higher risk of developing pneumonia or scarring after surgery. 
  • In some cases, marijuana and cigarette smokers can also experience airway hyperreactivity, a condition that makes breathing before and after surgery more difficult. 
  • Vasodilation, a relaxation of the blood vessel’s muscular walls, can increase heart rate and decrease blood pressure during surgery. This can change the way your body responds to anesthetics.

Can I ingest marijuana after plastic surgery?

There’s less research about marijuana ingestion after surgery; but whenever there’s research needed, it’s wise to err on the side of caution. Marijuana use can have benefits and relieve pain after surgery, but it could also be harmful. The associated increase in heart rate can be problematic, as can the risk of coughing, especially if you have had an abdominal procedure like a tummy tuck. Planning to smoke or use marijuana after your surgery? Ask Dr. Jalil or Dr. Somogyi about side effects and whether it’s a good idea for you.

Can I still book surgery if I’m currently a smoker?

This depends on when you plan to schedule your surgery for. For your safety and optimal healing, we require that all patients quit smoking at least two months prior to your surgery date. Realistically, many smokers require more than one attempt to successfully quit, so we recommend giving yourself a head start of more than the required two months. Remember, our goal is not to discriminate but to help you lower your risk level as much as possible and ensure a safe surgery and recovery.

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