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Why do I need to be nicotine free before surgery?

While we all know that smoking and nicotine are bad for your health in general, using nicotine before or after a plastic surgery is even more dangerous. If you are scheduled for a plastic surgery, you may have heard from your surgeon that you will need to be completely nicotine free for your procedure.

If you have had other general surgeries in the past while smoking or vaping and did not have any complications, you may be wondering why it is so imperative to stop using nicotine for a plastic surgery. However, plastic surgeries are performed differently than many other medical procedures and have high healing requirements, making it essential to be nicotine free.

What are some of the risks associated with nicotine use?

Tissue necrosis after plastic surgery is a major complication from nicotine use. Tissue necrosis occurs when blood flow is blocked to an area, causing death of living tissue. During a plastic surgery, tissue is often repositioned and blood vessels can be severed, making it even more important that the tissue has a solid blood supply through remaining vessels. Nicotine causes blood vessels to constrict, meaning that the blood flow to an area is restricted. When restricted blood flow is combined with the fact that there are already limited blood vessels, the tissue is at a much greater risk of dying. After tissue necrosis, the tissue cannot be recovered and you will permanently lose portions of your skin.

While tissue necrosis is one of the largest concerns after plastic surgery, there are a number of other possible complications. Other risks of nicotine use include:

  • Delayed healing
  • Loss of breast implants or nipples after breast surgery
  • Thickened or keloid scarring
  • Infection
  • Fat necrosis, leaving behind hard lumps
  • Blood clots, which can cause death
  • Heart attack or stroke

You will need to stop using all forms of nicotine before and after surgery, including smoking, vaping, nicotine patches, nicotine gum, and all other types of nicotine products. You will also need to avoid secondhand smoke and make sure you are not around other people using nicotine before and after your surgery. Even one time using nicotine can cause your blood vessels to shrink, so practice caution when you are around others who are smoking.



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