Cosmetic Surgery and Nicotine

Does Nicotine Cause complications in plastic surgery

Yes, it does.   Nicotine is known to shrink blood vessels which can contribute to loss of blood supply to vital tissues after some types of plastic surgery.

How does nicotine affect Surgery?

Nicotine can affect wound healing with all procedures but there are specific procedures where nicotine use can result in devastating consequences.  Most surgeries require an incision as access to underlying tissue.  In some types of procedures, the skin is elevated and separated from the deeper tissues creating a “flap”.   This skin flap now receives circulation from a limited amount of blood vessels.   Many flap surgeries also involve pulling the elevated tissue tightly, further compromising circulation.   The small vessels supplying these flaps are often just adequate to allow the skin to survive.  With nicotine, the microscopic vessels are narrowed significantly which has frequently been the cause of an otherwise successful surgery going poorly.  The complications can be devastating with complete loss of the elevated tissues.  There have been multiple cases of dead, black nipples that require removal after a breast lift or tissue loss of a large portion of the abdomen after a tummy tuck.  This can take months to heal and result in permanent cosmetic disfigurement.  

Just the nicotine in cigarettes or how about Vape?

Nicotine is nicotine.   Cigarettes, chewing tobacco, e-cigarettes, vaping and nicotine gum are all concerns.  

What types of surgeries are particularly concerning with nicotine use?

Procedures that involve elevation and tightening of skin are particularly risky for patients that are using nicotine.  Among others this includes: 

  • Facelift
  • Tummy Tuck
  • Breast Reduction
  • Breast Lift
  • Gynecomastia Surgery

How long do I need to stop nicotine before surgery?

Most plastic surgeons recommend (or require) 6 weeks without nicotine, in all of its forms, prior to any surgery involving a flap.  

https://www.plasticsurgery.org/news/blog/how-nicotine-sabotages-plastic-surgery

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