Are you a smoker who has been thinking about plastic or cosmetic surgery then think again!

Smoking and plastic surgery JUST DON’T MIX!!  But Why?? 

Firstly let’s think about how a plastic surgeon operates? We often undermine and separate the delicate layers of your skin and fat from muscle and underlying structures below the skins surface. As we separate the upper layers of skin and tissue we delicately pull, stretch, tighten and remove excess skin and fat.  That’s essentially what your plastic surgeon does while performing a facelift, tummy tuck, breast reduction, breast lift and so many other types of plastic surgery.  The tricky part about this is making sure the the skin and surrounding tissue remains connected to an adequate blood supply during and after surgery.   A decent blood supply is essential to keep skin, muscle, fat and structures like nipples alive.


3. Blood supply to muscles, 5/6 connective tissue, 7/8 fat, 9/10 epidermis and dermis (skin).  







As you can see from the diagram above, blood vessels infiltrate the delicate tissue layers delivering oxygen which keeps them healthy, happy and ALIVE!!  During operations like tummy tucks, facelifts, breast reductions and breasts lifts some, not all of those precious blood vessels are cut while the remaining intact blood vessels are responsible for keeping these delicate tissues alive.

So what does smoking have to do with blood vessels?

Smoking, in particular nicotine, causes blood vessels to shrink. Constricted blood vessels result in even less blood and oxygen getting to those already compromised tissues. A lack of oxygen causes tissue to die resulting in complications and often more surgery down the track!

Complications linked to smoking and nicotine

  • Death of tissue such as skin and fat can cause more severe scarring and hard lumps of scar forming in the fat layer
  • Delayed wound healing
  • Thick wide scars
  • DVT or blood clots
  • Increased pain
  • The need for revision surgery
  • loss of breast implants
  • Complications such as stroke, heart attack, pneumonia


If you are a smoker and you are considering cosmetic plastic surgery I will ask you to quit a minimum of 6-8 weeks before any surgery and I’m super serious about it!!  Stay away from nicotine products another 6-8 weeks (or for good!!) after plastic surgery in order to reduce your chance of complications and give yourself the best recovery and aesthetic result possible.   Ideally, get yourself into tip top shape 6 months before surgery, that includes ceasing smoking.

But what if I only have e-cigarettes and occasional Cannabis

Quit all forms of nicotine even 1 sneaky puff will shrink your blood vessels and reduce oxygen supply to your tissues!!  Smoking cannabis is a no no as carbon monoxide interferes with oxygen delivery to your tissues too)!!


  • Cigarettes
  • Nicotine gum
  • Nicotine patches
  • E-cigarettes
  • Smoking Cannabis

If your surgery is close and you’ve had a moment of weakness be honest with your plastic surgeon, it’s always better to be safe and delay surgery than be sorry!!

Dr Eddie Cheng is a board certified Specialist Plastic Surgeon in Brisbane, Australia.  Socialise with us @arplasticsurgery to learn more about Dr Eddie Cheng and our Team.


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