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I am going to have a tummy tuck. Will it be all right to smoke the day before the...

Q:

I am going to have a tummy tuck. Will it be all right to smoke the day before the procedure? Would there be a problem if I smoked right after the surgery?

A:

You should tell your plastic surgeon that you smoke.  Follow his/her policy.  In general, we require patients to stop smoking three weeks before surgery and three weeks after surgery for proper healing.

No nicotine patches or gum and avoid second hand smoke.

Some doctors require that the patient have a urine test prior to surgery.  If the result is positive, the patient's surgery is cancelled.  I tell my patients, "you are not cheating me, you are cheating yourself."

A:

Smoking definately interferes with wound healing. A Tummy tuck involves making an incision low on your abdomen (tummy) which after skin flap dissection, belly button relocation, some flank liposuction and possibly rectus muscle plication, the low incision is sutured close after removing the excess skin. This extensive procedure requires your body to heal not only under the skin but along the incision that will become a scar, hopefully barely noticable over time. If you smoke, we know from fairly reliable reports, that the wounds will not heal well, especially if you smoke before or after the procedure. I typically require patients to quit smoking for 2-3 months before and 3 months after tummy tuck surgery.  http://www.casas.md/index.php/tummy-tuck/

A:

There are many harmful substances in cigarettes. Nicotine and carbon monoxide are two examples. Nicotine causes the blood vessels to constrict and limit blood supply, while carbon monoxide essentially limits the oxygen supply to the tissue by tying up the hemoglobin in red blood cells. Tissue that is healing has an increased need for the nutrients that the blood supply brings. Oxygen is a key element needed for healing.

One significant complication that may occurs in surgery where flaps are raised (tummy tucks, breast lifts, facelifts, etc) is that some tissue may die due to inadequate blood supply and oxygen supply. In my practice of Plastic Surgery, I will not knowingly perform a tummy tuck on a patient who is smoking.  To me, there is no question; smoking is potentially dangerous before and after the surgery.

 

A:

 In a word, "NO."  Smoking releases cyanide which causes decreased oxygen delivery to your tissues, as well as Carbon Monoxide which hampers hemoglobin's ability to carry oxygen.  Finally, nicotine squeezes blood vessels and chokes off blood supply to tissues that need to heal after surgery.

My advice is to stay off all smoke, second hand smoke, cigarettes, nicotine gum/patch/inhaler for 6 weeks before surgery and 6 weeks after surgery.

A:

 Smoking the night or day after a tummy tuck not only isn't the "right" thing to do, but rather is a "dangerous" thing to do.  Smoking interferes with blood flow.  You need blood flow in order to heal from a large operation like an abdominoplasty.  

Don't risk a large non-healing wound by smoking within 3 weeks either before or after a tummy tuck.  If your surgery is soon, inform your surgeon and postpone.

This is not a small issue.  Speak to your surgeon, and get help with smoking cessation.

Good luck!

-Evan Sorokin MD FACS

A:

Nicotine taken in by smoking, chewing, patch or any other manner causes vasoconstriction. That means that it causes the blood vessels which supply needed oxygen to the tissues to narrow and reduce the flow of blood where it is needed most. The result of that can mean wound healing issues resulting in delayed healing, wound breakdown, prolonged time off work, possible additional surgery. In addition, there are possible problems with anesthesia. 

So, my suggestion is that if you are going to spend good money for a procedure and you wish to have great results, why do anything that can compromise the experience?

 

William H. Gorman, M.D. - View Other Answers by this Doctor
Austin, TX

A:

Smoking is detrimental to healing either before or after a surgical procedure.  Nicotine cuases constriction of the capillaries which can lead to problems with healing including even  loss of skin and other tissue.  Plastic surgery often involves moving tissue in such a way that the blood supply is stressed anyhow in the healing period so plastic surgical patients are especially vulnerable to the effects of smoking.  Also smoking increases risks with anesthesia.  Talk to your plastic surgeon about the minimum lenght of time to stop smoking before and after the procedure and consider delaying the plastic surgical procedure  if you are not able to stop smoking at this time. 

Susan E. Downey, M.D. - View Other Answers by this Doctor
Los Angeles, CA

A:

Smoking in the period two to three weeks before and after surgery has been shown to adversely affect wound healing.  Your surgeon can not predict if you will have a problem however why take an unnecessary risk of increasing complications. You do so at your own risk.

Richard B. Linderman, M.D. - View Other Answers by this Doctor
Carmel, IN

A:

 No, you do not want to smoke before and after your procedure. Smoking decreases circulation to the skin, and as a result you are at much higher risk for complications such as poor wound healing, skin loss, umbilical loss, and worsened scarring. I advise complete cessation of smoking 4-6 weeks before and after a procedure such as an abdominoplasty. 

A:

Tummy Tuck can really stress the blood supply to tissues.  Any use of nicotine in the period before or after surgery can create horrible complications with Tummy Tuck Abdominoplasty Surgery. Nicotine puts blood vessels into spasm and tissue that otherwise would live can be killed off. For my patients, I ask that they stop all forms of Nicotine for at least 6 weeks before and 6 weeks after surgery. But then again, I see patients from around the world and am trying to really minimize complications.

Hope this helps,

Michael Bermant, M.D. Board Certified American Board of Plastic Surgery

A:

Smoking just prior or after a tummy tuck/abdominoplasty can be a disastrous thing to do.  This is ill-advised as it will greatly increase your risk for poor wound healing and skin necrosis.  Many plastic surgeons, including myself, will have patients refrain from any tobacco or nicotine use for 2-4 weeks before and after surgery to minimize the risks.

A:

Smoking and elective cosmetic surgery do not go well together.  Certain procedures are less susceptible to wound healing problems than others but the reasons for stopping are clear.

Smoking reduces the amount of oxygen in the blood. The nicotine causes constriction or tightening of the blood vessels. What this means is that less blood makes it to a healing wound and the blood that makes it has less oxygen. The combination leads to an increase in wound healing problems such as tissue loss and wide scars.

When you are having elective surgery the goals are to achieve the best possible results. Smoking is something that can be controlled and eliminated to improve your results. Smoking before and immediately after a tummy tuck will increase your chances of losing abdominal skin and creating wide problematic scars.

I hope this was helpful. 

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