The Effects of Smoking and Plastic Surgery

Written by WD Staff, Skin Care Specialists on September 29, 2014 2 Comments

We all know that smoking is bad for your health, causing chronic injury to many organ systems including our lungs, blood vessels, heart, and skin. Continually inhaling the estimated 7,000 chemicals found in cigarette smoke is associated with increased risk of developing lung cancer, heart disease, and stroke. The contents of tobacco products, particularly nicotine play a significant role if the smoking individual is interested in a plastic surgery procedure.  As it relates to cosmetic surgery, smoking can increase risks associated with surgery by compromising the healing process.  Specifically, nicotine causes profound shrinking of blood vessels all over the body, so that the special cells that need to travel (in blood) to get to the healing areas cannot perform their function.  This happens regardless of whether the patient smokes, or chews nicotine gum, or is on a nicotine patch.

Plastic Surgery Relies on Blood Supply

Many plastic surgery procedures involve reshaping or moving segments of tissues from one location to another, with the goal of improving appearance, or function, or both.  For this to happen, a portion of the blood supply to the tissue must be cut by the surgeon, but not enough to cause problems.  This is what takes place in a facelift, or tummy tuck, or breast lift procedure for example.

During these surgical procedures a portion of the blood vessels that carry blood to the area are severed on purpose. The remaining blood supply is more than sufficient under normal conditions, but become severely less in patients actively using nicotine-containing products.  Insufficient blood flow prevents tissue from getting enough oxygen to survive; resulting in the destruction of tissue and/or the inability to heal properly.  This leads to wound healing problems, or even loss of large amounts of skin in a process called necrosis.  Thus it is critical that an adequate blood supply remains to the operated area to allow proper healing.

Smoking Increases Procedure-Related Risks

Smoking’s negative effect on the circulatory system and blood supply is well documented. Smokers who undergo any surgery have an increased risk of:

  • Experiencing some form of oxygen shortage
  • Developing blood clots
  • Contracting an infection

In some cases a patients risk’s stemming from long-term smoking may disqualify them from being able to undergo a cosmetic procedure.

Smoking Prevents Proper Healing

Nicotine and other chemicals in cigarettes make blood stickier and more likely to clot, thus clogging capillaries and blood vessels. Unnecessary clotting and blood thickening diminishes blood flow to and from the operated area.

Additionally, carbon monoxide, another dangerous cigarette content can lower the body’s overall blood oxygen level.


What’s the moral to this story? If you’re currently a smoker and thinking about undergoing a cosmetic procedure, stop smoking! Most ethical surgeons will require patients who smoke to quit nicotine-containing products for some time before (up to four weeks) and after surgery (up to four weeks) depending on the patient and the procedure being planned.

WD Staff

A united group of skin care specialists from Westlake Dermatology & Cosmetic Surgery, Austin's leader in Dermatology and Plastic Surgery. Articles posted under WD staff are authored through combined contributions from our entire team, including Plastic Surgeons, Dermatologists, Aestheticians, Physician Assistants, Aesthetic Nurses, and Patient Coordinators.

2 Responses to “The Effects of Smoking and Plastic Surgery”

  1. Avatar Heather Furnas, MD says:

    This is an excellent blog post about the effects of cigarette smoking on the skin. I’ll definitely refer my patients!

  2. Avatar Anna says:

    It is necessary to stop smoking and using any nicotine containing products at least 3-4 weeks before a breast augmentation procedure. Smoking causes vasoconstriction so it decreases the amount of oxygen in the blood and decreases the amount of blood traveling to the body tissues. Smoking and use of nicotine can cause wound formation, high rates of capsular contracture, aging of skin and the collagen break down.

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