Why is nicotine bad for plastic surgery?

29 April 2022

Pack of cigarrettes with one poking outBy plastic surgeon Dr Dirk Kremer

It’s no secret that over time, smoking has negative effects on our health, wellbeing, and physical appearance - especially our skin. In fact, smoking is a significant contributing factor that can drive so many people to cosmetic procedures such as facelifts and eye bag removal, among many others in the first place.

So, there are clearly plenty of benefits to quitting smoking. If you are planning to have a cosmetic surgery procedure, this is even more important as it’s vital that you stop smoking well in advance of your surgery.

If you’re a smoker, continuing to smoke before and after your cosmetic surgery is really going to impact your body’s ability to heal effectively, while also placing you at far more risk during the actual procedure.

This makes quitting smoking before plastic surgery a no-brainer. It should be a priority in the months prior and remember it’s not just your plastic surgery that will benefit from you giving up nicotine - you’ll also be able to enjoy benefits on your overall health in the long term.

Avoid all forms of nicotine before and after your plastic surgery procedure

When I say give up smoking before plastic surgery, I don’t mean just cigarettes. It’s all forms of nicotine that needs to be avoided as this is the ingredient contained within tobacco that can negatively affect the healing process following cosmetic surgery. Whether you’re a user of nicotine gum or even using nicotine patches in an attempt to kick the habit, you should make sure you wean yourself off these products as well in advance of your procedure.

Other popular products containing nicotine that will also need to be avoided before and after cosmetic surgery include cigars, snuff, pipes, chewing tobacco, e-cigarettes, and vaping.

How soon before plastic surgery should you stop smoking?

Smokers should begin the journey of no longer smoking before their procedure is scheduled as soon as possible. The earlier the better. In fact, the minute you begin considering cosmetic surgery would be the best time to kick the habit.

If you believe quitting smoking forever is not an option, then stopping smoking at least four to six weeks before your surgery is scheduled will reduce the risk of many complications, though ideally, you’ll be able to stop smoking 8 weeks before at a minimum.

What plastic surgery risks are associated with nicotine?

There are many nicotine risks that are linked with plastic surgery and the subsequent recovery period that follows.
Some of the most common risks include:

A delayed healing process

Any form of nicotine intake affects the nutrients present in your blood, and smokers tend to lack vitamin C which is a vital vitamin that’s required to both aid wound healing and help with the correct forming of scars. Nicotine negatively impacts both your health and immunity.

Because nicotine is a vasoconstrictor, it causes the blood vessels in the body to shrink, which results in lesser blood flow and therefore less oxygen flow to the tissues. All in all, this is not good at all for the healing process and will inevitably prolong the healing process as your body will struggle for longer to heal and recover.

Risk of infection

A delay in the healing process also opens up a higher probability of your surgical wounds becoming infected before they can fully heal. Wounds will be more vulnerable to infections for a longer period of time, and as nicotine compromises the immune system, your body will be less adept at fighting off infections by itself.

Nicotine increases the risk of bacteria contamination, and in serious cases, a staph infection, which leads to blood poisoning and potentially toxic shock syndrome.

The loss of skin

As mentioned, nicotine causes blood vessels to contract, and this lessens the supply of oxygen to the skin tissues. Some procedures, such as a breast lift or tummy tuck, means large incisions are made which already restricts the blood flow and supply of oxygen to the skin, so nicotine will naturally reduce this even further.

Starving the skin of vital oxygen means its at serious risk of dying, and this can result in the loss of cheek skin after a facelift procedure, loss of nipples or areolas during any type of breast surgery, or loss of belly skin following a tummy tuck.


There will be an increase in the risk of any potential complications that are associated with your particular cosmetic procedure.

Blood clots

Smokers experience an elevated risk of developing blood clots during surgery, or deep vein thrombosis, alongside many other circulatory diseases and strokes. With potential risks already in place with plastic surgery, regardless of how small, the last thing you want to do is add to those risks unnecessarily.

Carbon monoxide from smoke

As well as the risks that nicotine brings, carbon monoxide in cigarette smoke can add to that. Carbon monoxide decreases the oxygen carrying capacity of haemoglobin in the blood, which ultimately has the same effect as the vasoconstrictor effect of the blood vessels and can therefore lead to tissue dying.

So, with non-smokers and nicotine-avoiders experiencing a far better healing process and overall cosmetic procedure, as well as a much lesser exposure to risks and complications, it goes without saying that giving up smoking before your plastic surgery most certainly makes sense.

Learn more: The risks of smoking before and after plastic surgery

Keen to learn more a particular cosmetic procedure? If so, don’t hesitate to contact me here at Harley Street Aesthetics in the heart of London to discuss your personal situation and options. Call 0845 519 7232, e-mail info@harleystreetaesthetics.com or simply complete the online contact form.


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