Two weeks without nicotine changes wound healing measurably. It is the single most effective thing a patient can do.
Nicotine constricts small blood vessels, reducing oxygen delivery to healing tissue. In practice that means higher rates of wound breakdown, skin necrosis in facelifts and tummy tucks, graft failure in hair transplants and implant failure in dentistry.
Stop at least two weeks before surgery and stay off for at least two weeks afterwards, four is better. Vaping and nicotine patches count: it is the nicotine, not the smoke, that constricts vessels.
Stop 48 hours before surgery: alcohol affects clotting, anaesthesia and hydration. Afterwards, avoid it while taking painkillers and antibiotics. Bariatric patients need particular caution, absorption is faster and tolerance far lower after surgery.
Patients sometimes under-report. Nicotine testing is used before high-risk procedures such as facelifts and abdominoplasty, because operating on a smoker changes the risk profile enough to justify postponement.
For high-risk procedures we may postpone rather than accept a preventable complication. We will always tell you this in advance, not on the day.
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Your country code fills itself in. A surgeon reads them and replies with what is realistic, including when the answer is no.
