Jul 27, 2016

No matter how much you smoke — or what you smoke — please tell us the truth when we ask.

You’ll be asked many questions by your doctor while preparing for cosmetic surgery, including several about your smoking habits. It is very important that you answer these questions honestly to prevent any serious complications.

Because of the negative stigma that society has placed on smokers and smoking you may be embarrassed to admit that you smoke and/or smoke as much as you do (including vaping — vaporizers do not decrease the amount of nicotine in tobacco, they only eliminate the smoke). You may also be embarrassed to tell your doctor that you smoke marijuana. You must, however, tell us the truth! No one will judge you. And doing so will prevent some very serious complications during and after your surgery.


Why are we concerned with your smoking habits? There are many serious side effects, including longer healing time, worsened scars and more complications in patients who smoke. Here are the reasons why …

  • The nicotine found in cigarettes is a vasoconstrictor. This means it decreases blood flow to the tissues. It essentially crimps down on your blood vessels. This can cause a very bad outcome in some surgeries — like breast lifts and tummy tucks, where there are long incisions made during the procedure. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die. In a breast lift this can cause part of the breast or nipple to die; in the case of a tummy tuck, it can result in part of the belly tissue dying, resulting in a very bad outcome.

  • Carbon monoxide steals oxygen from your tissues. There is carbon monoxide in both tobacco smoke and marijuana smoke — and carbon monoxide decreases the oxygen-carrying capacity of hemoglobin in the blood. The decreased oxygen levels will have the same effect as nicotine described above — presenting the risk of tissue death following surgeries that decrease the blood flow to tissues.

  • Smoking causes coughing. Both tobacco and marijuana smoke are bad for your lungs. The smoke disrupts the lining of the lungs and bronchi and can lead to coughing episodes, which can be extremely dangerous after surgery. Having a coughing episode post surgery can lead to internal bleeding that can lead to hematomas and complications.

  • Anesthesia is affected by Marijuana. Marijuana can have drug interactions with certain anesthetic drugs. So it is obviously very important to share with us the truth about your marijuana use to best prepare your anesthesiologist.

As you can see … smoking — tobacco and/or marijuana — is detrimental to your surgery outcome. By not smoking, and maximizing the oxygen levels and blood flow going to your tissues, you will get better healing, fewer complications, and less severe scarring. (Edible marijuana is far less detrimental, but still be honest about your use so that you can have the best outcome.)

Here at Kevitch, Chung & Jan, we strongly urge our patients to be smoke-free for at least four weeks prior to — and after — their cosmetic surgery. (This includes second-hand smoke as well as smoke cessation aides such as gums and patches which contain nicotine.)

Ideally, we’d like all of our patients to continue to remain smoke-free well beyond four weeks, for the rest of their lives. We are doctors of medicine first and as such we are concerned with the overall health and well-being of every person who visits our practice. Smoking is a terrible addiction which adversely affects your health in so many ways and ruins so many lives. We are delighted when we hear from former patient (and the spouses of former patients) that their cosmetic surgery was the one thing that finally got them to quit smoking.