Cosmetic Surgery and Smoking

Most of us know by now that cigarette smoke stains our teeth, prematurely ages our skin and can lead to cancer, but there are other reasons we do not recommend our cosmetic surgery patients smoke. Smoking has a serious impact on the results of your cosmetic surgery. Consequently, you may have noticed that most candidates for our surgical cosmetic procedures are “non-smokers”. So, how does smoking specifically effect your cosmetic surgery results?

What does smoking do to your cosmetic surgery?

Nicotine (of any kind ex. cigarette, nicotine gum, chewing tobacco) constricts small blood vessels resulting in worse blood flow to skin after surgery. In addition, smoking increases carbon monoxide levels in the blood resulting in less oxygen to the tissues. Following surgery, oxygen is particularly necessary for its healing powers and its ability to fight infection, transport antibiotics and other important medications and help keep skin tissue alive. Below is a list of important studies involving the effects of smoking and cosmetic surgery.

  • Studies have shown that smokers are 12.5 times more likely to develop skin loss with delayed healing in facelift surgery than non-smokers.
  • In one study, smokers having tummy tucks had a 47% chance of developing a wound at the incision site. These types of wounds may result in increased costs and delayed healing because of the need for wound care devices such as a wound V.A.C. Some wounds may take months to heal and may even require skin grafting.
  • Smoking a single cigarette can decrease the blood flow to the thumb by 24%.
  • A research study found that 85.3% of patients that said they quit smoking 2 weeks before surgery in fact kept smoking. Realize that you are taking significant risks by continuing to smoke when you are asked to quit.

Cosmetic Surgeries most affected by smoking

Tummy tucks, facelifts, breast reductions and breast lifts are the top procedures most affected by tobacco and nicotine use. These types of surgeries are unique in that the skin is undermined and as a result the blood supply to the skin in compromised. In healthy non-smoking patients, the risks of wound breakdown and healing is low. However, in smokers, the risks of skin loss, delayed healing and scarring are increased. The following are pictures showing major wound with skin loss after cosmetic procedures. Smoking increases these problems after surgery!

How do I avoid this?


Studies show that quitting smoking (and all nicotine products) 3-4 weeks before surgery and 3-4 weeks after surgery will decrease the likelihood that you will develop a wound problem. You will still be at a slightly higher risk than a non-smoker.If you need help quitting there are prescription medications that we can prescribe to help you quit.

Smoking Policy at Advanced Surgical Concepts

  • We REQUIRE that all smokers COMPLETELY QUIT smoking (and any nicotine products) a minimum of 3-4 weeks before surgery and 3-4 weeks after surgery. After this time period, if you wish to resume smoking, that is your choice.
  • Some procedures do not require that you quit smoking but we still recommend that you quit for optimal healing.
  • We may request you have a nicotine test…. if the test is positive we may refuse doing your surgery.

For a complimentary consultation call (423) 648-4011.