Why smoking is incompatible with body contouring
Nicotine causes acute vasoconstriction of the small blood vessels supplying skin and subcutaneous tissue. Carbon monoxide in cigarette smoke reduces oxygen delivery. The combined effect at incision sites — where blood supply is already compromised by surgical dissection — is wound healing failure.
The relative risk of wound complications is several times higher in smokers undergoing body contouring compared to non-smokers — particularly for procedures involving extensive dissection (abdominoplasty, brachioplasty, lower body lift). Wound complications in body contouring can mean skin necrosis, exposed deep tissue, prolonged open wounds, infection, and severe scarring.
Cessation requirements
- Minimum 4 weeks of complete cessation before surgery for any body contouring procedure
- Minimum 4 weeks of cessation after surgery
- "Complete" means no cigarettes, no vaping, no nicotine replacement (patches, gum) — all forms of nicotine cause the same vasoconstriction
- Cannabis smoking shares the carbon monoxide effect and should also be stopped
Verification
Patients are asked directly about smoking. Self-reported cessation is generally accepted, but patients should understand that proceeding while continuing to smoke meaningfully raises their personal risk — and the consequences of wound failure are theirs to live with.
Former smokers
Patients who quit smoking more than 1 year ago have largely normalised cutaneous microcirculation and approximate the non-smoker risk profile. Patients quit between 6 weeks and 1 year ago retain some residual elevated risk but are generally acceptable candidates.