Many patients have asked me if they can smoke cigarettes up to the time of their cosmetic surgery. The procedures most often in question are breast lifts with or without implants, breast reductions, tummy tucks and facelifts. Simply put, smoking and these procedures can be recipes for disaster. I strongly encourage smokers to quit smoking before these surgeries, as tobacco, nicotine, and carbon monoxide, all of which are within cigarettes, can impede wound healing. In operations which involve lifting and tightening large amounts of skin, this can result in skin separation, or worse yet, skin loss.
Most board-certified plastic surgeons are selective in the procedures that they will offer to tobacco users. Some procedures that do not require a significant amount of skin lifting, such as rhinoplasty, liposuction and breast augmentation, are thought to be somewhat safer to perform in smokers than procedures that require more skin manipulation. For that reason, most plastic surgeons will perform these surgeries in smokers, but will still extend significant disclaimers and warnings.
Virtually everyone knows that smoking can cause pulmonary problems, heart disease and lung cancer. For those reasons alone, I encourage all patients to quit using tobacco products. In regards to cosmetic surgery, tobacco usage can cause significant problems with healing. Because cosmetic surgery is elective, it only makes sense to quit tobacco usage prior to surgery to minimize this potential risk.