Dr Kumar requires complete abstinence from all nicotine — not just smoking — for eight weeks before and eight weeks after body contouring surgery following weight loss, and six weeks either side for other procedures.
That includes vaping, patches, gum, lozenges and pouches. The rule is about nicotine, not about smoke.
Why it is nicotine, not smoking
Nicotine constricts the small blood vessels that supply the skin. Body contouring operations lift large areas of skin and leave them depending on a reduced blood supply at the edges — exactly the tissue nicotine starves.
That is why nicotine replacement does not solve the problem. Patches and gum deliver the drug that causes the vasoconstriction. Vaping delivers it too. Swapping one nicotine source for another achieves nothing surgically.
What it actually causes
| Problem | Consequence |
|---|---|
| Wound edge necrosis | Skin at the edge of the wound dies and has to heal by scarring, or needs further surgery |
| Wound separation | A wound that opens, weeks of dressings, a much wider scar |
| Infection | Poorly perfused tissue resists infection badly |
| Fat necrosis | Firm lumps under the skin that may take months to settle |
| Nipple or umbilical loss | Uncommon, but catastrophic when it happens, and nicotine is a major factor |
| Anaesthetic risk | Airway irritability and respiratory complications |
These are not theoretical. They are the reason surgeons are firm about this to the point of declining to operate.
Why surgery may be declined
If you are still using nicotine, Dr Kumar may decline to proceed. That is not a judgement about you — it is that the risk of a serious wound complication in a large skin excision is high enough that operating would not be in your interest.
It is better to postpone by two months than to have a wound break down across a hip-to-hip incision.
The practical plan
- Set the stop date eight weeks before surgery, and book surgery around it rather than the other way round.
- See your GP about support. Note that nicotine replacement does not meet this requirement — ask about non-nicotine options.
- Tell the truth at your consultation. A surgeon who knows can plan a smaller operation or stage it. A surgeon who does not know cannot.
- Stay off it for eight weeks afterwards. Healing continues long past the first week, and this is when scars widen.
- Be aware you may be tested. Do not be surprised if this is checked.
Passive smoke and other exposures
Household exposure matters, and it is worth raising with whoever you live with. It is also a reasonable moment to consider stopping for good — several months off nicotine around surgery is the longest break many people have had.
Common questions
Can I use patches instead? No. Patches deliver nicotine, which is the problem.
Is vaping acceptable? No.
What about one cigarette a week? No. The requirement is complete abstinence.
Is six weeks enough? Six weeks for other procedures; eight for body contouring after weight loss, which involves larger skin flaps.
What if I slip? Tell the practice. Delaying is manageable; a wound breakdown is not.
Next step
If you use nicotine and want this surgery, the most useful thing you can do today is pick a stop date and tell your GP. Then bring a GP referral to a consultation — it is required to see Dr Kumar. Call 1300 267 726. More about preparing for surgery and the risks. Background at My Weight Loss Journey.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
