Smoking (or the use of any nicotine containing product) reduces blood supply to all tissues throughout the body. It also affects the effectiveness of the cilia to remove foreign particles from the lung and bronchi.
The latter increases your risks of developing pneumonia or having other lung problems. Since we reduce the blood supply of the abdominal skin with the surgery, adding smoking markedly increases the risks of wound healing problems and, also, loss of skin.
Additionally, smoking increases the risk of developing blood clots in the legs that can dislodge and go to the lung which could cause death. This risk is already increased in tummy tucks over other surgeries. Adding smoking makes this risk prohibitively high.
Since it takes from 1-2 months for the effects on the body of smoking (or nicotine use) to resolve, I usually like my patients off all nicotine containing products for 8 weeks before abdominoplasty.
You should be OK if you stop smoking completely (and do not use any nicotine products) from today on. Recovery is variable, but, again, smoking cessation should make it easier. (Robert T. Buchanan, MD, Highlands Plastic Surgeon)
Smoking and Tummy Tucks
Smoking will increase your risk of skin necrosis for any form of plastic surgery. Because most of our work is often at the level of the skin, or is at least somehow altering the tension on the skin (usually increasing it), we are very sensitive to smokers. In my practice I try not to operate on smokers.
If the patient quit for 7 months, as is your case, then I don’t consider them a smoker anymore You should be careful to not even so much as smell second hand smoke. or wait until later in life to quit for real. Don’t forget that you also have to be off ciggs for over a month after surgery as well! (Ricardo A. Meade, MD, Dallas Plastic Surgeon)
Tummy tuck complications from smoking
Nicotine will compromise the healing process and should be avoided for a minimum of 3 weeks before/ after surgery. This includes cigarettes as well as all nicotine products (including patches and gum). The lack of blood flow caused by nicotine can lead to skin necrosis and wound separation.
The discomfort from tummy tuck surgery is well controlled with pain medication. Discomfort is improved once your drains are removed (usually 7-10 days following surgery). The discomfort associated with a tummy tuck should be less than a c-section due to the fact the muscles are not cut with a tummy tuck. (David A. Robinson, MD, Munster Plastic Surgeon)
You need to be nicotine free for atleast 2 weeks, best if 4 weeks. You can not use any nicotine products, including patches and gum. I generally test the urine the day of surgery for any of my patients that have a history of smoking.
If the test is positive the surgery is cancelled. Smoking causes serious complications in plastic surgery and needs to be avoided as mentioned above. (Farbod Esmailian, MD, Orange County Plastic Surgeon)
No tummy tucks for current smokers
The issue with nicotine from any source is that it is a vasoconstrictor, meaning that it causes blood vessles to close and reduce the supply of oxygen to the tissues. With procedures such as tummy tucks, facelifts, and breast lifts, the skin is undermined so that it can be repositioned and then put on some stretch, which is the whole idea. Both of these cause a diminished blood flow so nicotine is snough to cut it off completely and the tissue dies. So quit now, no patches or gum, and remember even one “dose” is enough to cause serious problems during the healing phase. (Richard Baxter, MD, Seattle Plastic Surgeon)
As long as you avoid all nicotine products including gums and patches for 4 weeks before and after surgery, your risk is as low as it can be for you – not down to that of a non-smoker but as low for you as possible. (Richard P. Rand, MD, FACS, Seattle Plastic Surgeon)
You should certainly ask your surgeon about this specifically and discuss your history frankly. The smoking history and the acute use of tobacco prior to surgery will increase your risk of complications.
This includes pulmonary risks as well as local healing risks. You cannot do anything about your history but you can try to get off the tobacco immediately and certainly for at least the two weeks or so before your surgery.
Your surgery may modify his treatment, be less aggressive in dissection or using less tension. He may choose to limit any liposuction. If you do continue to smoke, you and your surgeon should discuss the possibility of postponing the surgery until you can quit. Part of the decision has to do with asking how much each of you would regret surgery if you continued to smoke and had a complication related to smoking. (Robin T.W. Yuan, MD, Beverly Hills Plastic Surgeon)
You should definitely stop smoking completely prior to your tummy tuck; most surgeons will not operate on active smokers. Even one cigarette a day has enough nicotine to affect your blood circulation, and it would be a shame to go through surgery only to have a complication which could have been prevented. The risks of scarring, skin loss, and poor wound healing all increase with smoking. In addition, smokers tend to have more secretions during anesthesia. If you stop completely now, you should be ready for your tummy tuck in 7 weeks.
In terms of recovery, a tummy tuck should be a little bit easier than a C-section. During a C-section, your muscle is cut, which is much more painful than having the muscle simply tightened.
You will definitely be sore – akin to doing a very large number of sit-ups – but severe pain would be unusual. (Nina S. Naidu, MD, FACS, New York Plastic Surgeon)
There are few habits and drugs which have been keeping doctors and morticians as busy as Tobacco. (Alcohol is not even a close competitor). Nicotine has adverse effects on literally EVERY organ system in the body from the brain, heart, skin, blood vessels, lungs even sexual function. It has been shown that smokers have a poor blood supply due to chronic spasm.
Oxygenated blood literally does not flow well through skin and ESPECIALLY skin which has been elevated and depends on being supplied from a distant origin (as is the lifted skin of a Facelift or a Tummy Tuck). As to just how much smoking is really safe? – No one really knows. a better question to you Amo would be How lucky do YOU feel?
How much risk are you willing to assume? The fact you use the term NECROSIS (Greek for Death) tells me either that you have a medical background and or that your Plastic surgeon has ALREADY educated you on the seriousness of nicotine exposure in the peri-operative period. Opinions vary, but I think 7 weeks free of ANY nicotine (gum, second hand, chew) should be sufficient for you to have your surgery. STAY AWAY FROM SMOKERS AND DO NOT SOCIALIZE WITH THEM. (Peter A. Aldea, MD, Memphis Plastic Surgeon)