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Risks Associated With Smoking and Undergoing Cosmetic Surgical Procedures

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Svetlana M. Danovich MD, PhD, FACS

Although there are always risks associated with all types of cosmetic surgery, smoking cigarettes can significantly increase these risks and have other adverse effects. Even second hand smoke, nicotine gum and patches can contribute to less than optimal surgical results. Cigarettes contain over 4,000 chemicals and cigarette smoking is the leading cause of lung cancer and COPD.

The nicotine in cigarettes causes narrowing of the blood vessels (vasoconstriction). This decreases blood and oxygen flow to the tissues, inhibiting cell healing and increasing risk of skin necrosis. In addition, tissues are deprived of oxygen due to increased carbon monoxide levels in the blood from smoking. This is an issue with any surgery, but becomes particularly concerning when it comes to facial plastic surgery where we want the best aesthetic results for the patient as possible.

Other issues that can arise when combining smoking and cosmetic procedures are infections, increased pain, delayed healing, tissue or fat cell death, blood clots/blood vessel damage, increased scarring or loss of skin. 

How long before and after plastic surgery should you not smoke?

Our practice recommends refraining from nicotine use at least eight weeks prior to cosmetic surgery, longer if you have an extensive history of smoking. For optimal healing, we recommend patients not smoke for a minimum of six weeks subsequent to surgery. There still remains a risk of surgical results being affected even with cessation of smoking before and after surgery.

Are E-cigarettes and marijuana dangerous before and after cosmetic surgery?

During your consultation with Dr. Danovich, you will be advised not to smoke before and after surgery. This includes not only cigarettes, but also substitutes such as nicotine gum, chews or patches. In addition, you should avoid E-cigarettes, vaporizers, cigars, pipes and hookah. These contain nicotine and have the same damaging effects on blood vessels.

Although marijuana does not contain nicotine, it does contain carbon monoxide when smoked, which can result in tissue death after surgery. In edible form this is not an issue. At your initial consultation, be sure to discuss marijuana use with your surgeon.

Generally, smoking in any form can be detrimental to your surgical result. In order to ensure the best possible outcome, be frank with your surgeon and yourself about your use of nicotine and marijuana.

Achieving the best surgical outcome

An extensive amount of time, thought and planning goes into preparing for your cosmetic surgery. In order to do everything possible to achieve the most ideal results, we recommend ceasing nicotine use indefinitely.

“Smoking and cosmetic surgery do not go well together.” Svetlana M. Danovich MD, FACS