The Effects of Smoking on Plastic Surgery

A Q & A with a board certified plastic surgeon

woman smoking cigarette
Zero Creatives/Cultura/Getty Images

Pretty much everyone knows that smoking is a danger to your health in general. But did you know that smoking significantly compromises your body's ability to heal and recover after surgery? Smoking accelerates the aging process, and smokers have a higher risk of infection and other complications when they smoke before and/or after surgery

Obviously, smoking is not going to lead anyone to the fountain of youth.

So just in case you needed one more reason to quit smoking, I’m asking the question, “What is it that makes smoking such a no-no for patients undergoing cosmetic surgery?” Here is what Maryland-based board certified plastic surgeon, Dr. Adam Tattelbaum, has to say about it.

Q: How does smoking inhibit healing and recovery from surgery?

Dr. Tattelbaum: Nicotine closes the blood vessels responsible for bringing oxygenated blood to the tissues. In addition to its healing power, oxygen also fights infection and helps to keep tissue alive, as well as being instrumental in delivering important medications like antibiotics. Furthermore, smoking clogs the lungs, and thus increases risk of pulmonary infection such as pneumonia.

Q: What are the worst-case scenario consequences of smoking after surgery?

Dr. Tattelbaum: Smoking significantly increases the risk of severe infections, pneumonia, and tissue death.

Q: How specifically does smoking accelerate aging of the face and body?

Dr. Tattelbaum: Due to the constriction of blood flow and increase of free radicals, smoking decreases the skin’s elasticity (leading to earlier sagging and wrinkling of the skin), and the constant repeated “puckering” action involved in puffing on a cigarette can cause lines and wrinkles around the mouth.

Q: Are there specific surgeries that you will refuse to perform on a smoker?

Dr. Tattelbaum:  Certain procedures which involve a lot of pulling or altering of blood supply would present more risk for a smoker. These procedures include face lifts, tummy tucks, and the use of tissue flaps as in reconstructive surgery.

Q: Aside from quitting entirely, how long do you recommend patients avoid smoking before and after surgery?

Dr. Tattelbaum: Ideally, the patient would quit altogether. Non-smokers enjoy better and longer lasting results, quicker recovery, and less risk. However, this is obviously not going to happen with a lot of patients. Generally, it is recommended that a patient avoid smoking for at least 3 weeks before and after surgery.

Reason #999 to Quit

In short, if you are considering plastic surgery, you may also want to seriously consider the idea that this is the perfect time to quit smoking. Surgery always entails some level of risk to your health (even, in rare cases, to your life). Smoking greatly increases those risks. If you are going to go under the knife for the sake of ageless beauty, don’t compromise (or even negate) your results for an addiction which has mostly likely already cost you plenty.


Need help quitting the sticks? Here are some resources (and motivation) to help you:

The Many Benefits of Quitting Smoking

Practical Tools to Help You Quit Smoking

Personal Quit Smoking Stories from Successful Ex-Smokers

Source: Interview with Adam Tattelbaum, MD, Rockville, MD, conducted on November 14, 2008