American Society of Plastic Surgeons
For Medical Professionals
5 years ago


I typically only smoked 4-5 cigarettes a day and I quit smoking 2 weeks ago. I am scheduled for a tummy tuck and breast reduction tomorrow. Should I wait longer for the surgery? I am apprehensive.

Procedure: Tummy Tuck
Location: West Greenwich, RI

Replies 7

Jonathan Zelken
ASPS Surgeon
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I generally recommend 4 weeks before and 4 weeks after. Tummy tuck and breast reduction are two of the riskiest operations in the context of smoking and complications. Might be better to wait, and I applause you for your attention to this important matter.

Best wishes,

Dr Jonathan Zelken

Jon Ver Halen

Dear Shayna W,

Hello and thank you for your question. I typically have patients stop smoking for at least 3 weeks from the time of surgery, and (preferably) not smoke at all after surgery. I recommend that you discuss this as soon as possible with your surgeon, so that you can make appropriate plans for the timing of your surgery. Good luck!

Jeremy Sanderson
ASPS Surgeon

I would definitely let your surgeon know. I don't worry about the tummy tuck becoming a problem due to the smoking as much as I do the breast reduction. Most surgeons recommend anywhere from 3 to 6 weeks off of all tobacco products before doing breast reductions. Unless I am only doing a very minor reduction, I require 4 weeks free from tobacco before proceeding.

Gregory Dowbak
ASPS Surgeon

Cancel surgery. Reschedule after you are nicotine free for one year. Anesthesia has a say in this too. I would get pulmonary function tests to see how much of your lungs have been damaged. Anything that burns produces tar, benzenes and aldehydes that not only damage lungs but are also carcinogenic. If there is significant damage, anesthesia should just cancel your surgery making the opinion of we Plastic Surgeons moot. If you cannot stop smoking, you should vaporize, that does not produce tar, benzenes and aldehydes but of course produces nicotine which is damaging to blood vessels precluding surgery in my opinion

Dallas Buchanan
ASPS Surgeon

No question about this one at all. Cancel your surgery and reschedule. This is an elective procedure and there is no reason to add the additional risk of recent nicotine use. It can compromise blood flow and healing and leave you with the possibility of poor incision healing, open wounds, and a whole other list of scary outcome. Why risk it? I usually ask patients to have a strict nicotine avoidance for 6 weeks before and 6 weeks after surgery if that helps, but the longer you wait the better and then after surgery, just don't resume at all!

Hope this helps!

Dallas R. Buchanan, MD, FACS

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Gary Tuma
ASPS Surgeon

I completely agree with Dr. Buchanan. I routinely check preoperative nicotine and cotinine levels prior to surgery and if they are positive then I would cancel surgery. I inform all the patients during the consultation stop 6 weeks before surgery and 6 weeks after. In addition vaping, nicotine gum or patch are also not acceptable.

Mark Deutsch
ASPS Surgeon

I agree with the other physicians, nicotine is a powerful drug that can stay in the bloodstream for several weeks after your last exposure and can lead to poor wound healing for your elective surgery. Ask your doctor for Chantix, many patients have had success with this or Wellbutrin.


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