The Effects of Smoking and Plastic Surgery

Dr. Michael Menachof Headshot
Dr. Menachof, MD, FACS has performed thousands of facial plastic surgery procedures in over 20 years of experience. He has been recognized as a Fellow by multiple academies, named one of America’s Top Facial Plastic Surgeons continually since 2003 and is featured in multiple national publications.

Cigarettes contain over 4,000 chemicals and they are detrimental to your health. Plastic surgery poses risks for any individual, no matter the procedure, but these chemicals significantly heighten the risks for smokers. If you smoke and are considering plastic surgery, consult an experienced plastic surgeon to discuss the procedure.

The Risks of Mixing Nicotine and Plastic Surgery

Cigarettes and tobacco products contain nicotine, an ingredient that can cause vasoconstriction, or narrowing of the blood vessels. This narrowing decreases the flow of blood and oxygen to the healing tissues after the procedure, which deters proper cell healing and increases the risk of skin necrosis on the wound.

Smoking also increases the level of carbon monoxide in the blood, which deprives tissues of oxygen. Blood supply is a major concern during any surgical procedure, but especially during facial plastic surgery where the visual outcome is important for the patient.

Mixing smoking and cosmetic surgery can specifically result in increased pain, loss of skin, infections, death of tissue or fat cells, delayed healing, thick scarring, permanent vessel damage, or blood clots. Speak with your surgeon about these concerns prior to your surgery, and partner together to avoid any of these potential healing risks.

Direct contact with nicotine products poses the highest risk for surgical complications, but second-hand contact with smoke can have similar effects. The same goes for nicotine gum or patches – both prior to and after a surgery, it is crucial that patients cease contact with nicotine, whether direct or second-hand, in order to prevent unwanted surgical results or health complications.

Smoking Before and After Plastic Surgery

Combining smoking and facial plastic surgery can be very detrimental to the healing process. It can be difficult to suddenly cut back on smoking, but we have specific recommendations for smoking habits before and after surgery.

How long before plastic surgery do I need to quit smoking?

Our practice recommends stopping use of nicotine products three weeks to one month before plastic surgery. If the patient has a long smoking history, there is a greater risk of complications, and we recommend stopping nicotine use even further out from the surgery date. Regarding smoking after surgery, we recommend that patients do not smoke for one month to six weeks after the procedure for optimal healing.

Even if patients stop smoking before and after plastic surgery, the patient’s history of tobacco use can still affect surgical results. However, quitting smoking and avoiding second hand smoke before and after the procedure is critical for surgery success. Speak to your surgeon for further recommendations about your smoking habits during these few months.

E-Cigarettes and Marijuana Dangers Before and After Surgery

In your initial consultation, your surgeon should tell you not to smoke cigarettes before or after surgery. This doesn’t mean that you can reach for a cigarette substitute. E-cigarettes, vaporizers, pipes, cigars and hookah contain nicotine and produce the same negative effects on blood vessels. The same goes for nicotine chews, gums, or patches. While these products can aide in weaning off of cigarettes for people, they are dangerous to use before and after surgery.

There is no nicotine in marijuana (weed), but there is carbon monoxide in marijuana smoke, which can result in tissue death after surgery. Marijuana in an edible fashion does not have nicotine or carbon monoxide effects. Make sure you speak with your surgeon about marijuana use in your initial consultation.

Overall, smoking – whether tobacco or marijuana – is detrimental to your surgery outcome. Be honest with your surgeon about your nicotine and marijuana use to ensure the best possible surgery outcome.

Best Overall Facial Surgery Outcomes

In order to get the best possible outcome after plastic surgery, we recommend ceasing use of nicotine products for life. Smoking and facial plastic surgery do not go well together, so make sure you communicate any concerns with an experienced surgeon. He or she will provide specific instructions for you throughout the process.


This blog was originally published in July 2018 and has been reposted in 2022 with updated information. 

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