How to Stop Smoking Before Surgery: Support from Dr Michael Kernohan

Dr Michael Kernohan is a Specialist Plastic & Reconstructive Surgeon based in Sydney. Many of his patients smoke or vape, and they often ask whether they really need to stop before surgery, how far in advance they should stop, and what happens if they cannot quit completely. 

Smoking affects the heart, lungs and blood vessels. It also reduces blood flow to the skin and tissues. This can make anaesthetic care more complex and can increase the chance of chest problems, wound issues and slower healing after an operation.

Stopping smoking before surgery is one of the most useful steps you can take to support your body. Australian and international guidelines suggest that stopping around four weeks or more before surgery can reduce some complications, and even a shorter period without cigarettes can still help. 

This article explains why stopping smoking matters before plastic or reconstructive surgery, how to plan a quit attempt, and where support is available in Sydney and NSW more broadly. It is not about blame. It is about realistic support, so you and your surgical team can plan together.

Are You Ready for Surgery? Find Out

Why Stopping Smoking Matters Before Surgery

How smoking affects your body during surgery

When you smoke, your lungs and airways are more irritated and produce extra mucus. Your heart and blood vessels work harder. Oxygen levels in your blood can drop. During and after surgery, this can lead to more breathing problems, a higher need for oxygen or a breathing machine, and an increased chance of chest infection.

Impact on wound healing in plastic and reconstructive surgery

For plastic and reconstructive surgery, smoking is also linked with a higher risk of wound breakdown, infection, delayed healing and, in some operations, loss of skin or tissue flaps. Dr Michael Kernohan, Specialist Plastic & Reconstructive Surgeon in Sydney, sees these effects in day-to-day practice. He often explains to patients that surgery puts stress on the body, and smoking adds extra strain. Stopping gives your heart and lungs a chance to work better and improves blood flow to healing tissues. As he tells many patients, “Surgery is a big event for your body. Stopping smoking before surgery is one of the practical ways we can lower some of the stress your body faces.”

What research tells us about quitting before surgery

Research has shown that people who stop smoking before surgery have fewer complications than those who continue. Systematic reviews and large studies have found that quitting in the weeks before surgery can reduce wound problems and other complications, and structured pre-operative quit programs can improve both quit rates and surgical outcomes.

Cost of Plastic Surgery Guide

Find out the cost of plastic surgery in Australia for your procedure.

How Long Before Surgery Should You Stop?

✓ Why earlier is usually better

There is no single rule that fits everyone, but the general message from surgical and anaesthetic groups is clear: the earlier you stop, the better. The Royal Australasian College of Surgeons notes that stopping several weeks or months before surgery is ideal, but even a few days can still help your body. ANZCA guidelines and other reviews describe surgery as a “teachable moment”, when people are often more ready to consider stopping.

✓ The four-week goal and shorter timeframes

Some resources suggest aiming to stop at least four weeks before surgery and to stay smoke-free afterwards, as this is linked with fewer wound and chest problems. Newer data also show that even a shorter break of two to four weeks, and sometimes even days, can still be helpful, especially when combined with nicotine replacement or other supports.

✓ Setting a realistic timeframe with Dr Kernohan

During your consultation in South West Sydney, Dr Michael Kernohan will ask about your smoking history and your planned surgery date. Together with your GP, he can help you set a realistic target. Some patients may be able to stop completely weeks in advance. Others may reduce and then stop closer to the date. The key point is that every smoke-free day adds up.

Planning a Quit Attempt With Your Healthcare Team

✓ Starting the conversation with your GP

If you are thinking about stopping smoking before surgery, the first step is usually a conversation with your GP. Your GP in Sydney, Melbourne or regional NSW can check your general health, look for other conditions that may affect surgery, and talk about which quit options are suitable for you. NSW and other state health services recommend including smoking status and quit support as part of the routine pre-operative assessment.

✓ Choosing a quit date and lining up support

Together with your GP, you can choose a quit date. Some people use the day of their pre-admission clinic or the week a major test is due. Others draw a line in the sand several weeks ahead of surgery. It can help to tell family and friends who are supportive, and to plan what you will do when cravings hit, such as stepping outside for fresh air, chewing sugar-free gum, or calling the Quitline.

✓ How Dr Kernohan fits quitting into surgical planning

During your consultation with Dr Michael Kernohan, Specialist Plastic & Reconstructive Surgeon in South West Sydney, will also ask about smoking and vaping. He may advise that certain procedures are only offered when you have stopped for a set period, especially for operations where blood flow to the skin is critical. This is not a punishment. It is about reducing the chance of wound problems or more serious complications.

Tools to Help You Stop Smoking Before Surgery

✓ Nicotine replacement therapy options

Stopping smoking can be hard, especially when you are already dealing with the stress of planning surgery. Many people need support. Evidence shows that structured quit programs and medication can increase the chance of success, and pre-operative interventions can lower complication rates. Nicotine replacement therapy (NRT) – such as patches, gum, lozenges or inhalers – can ease withdrawal symptoms by giving a steady, lower dose of nicotine without the harmful chemicals in smoke. Studies in surgical patients show that NRT, combined with stopping smoking, does not increase wound problems and may even reduce some complications. Your GP or a specialist clinic can advise on which products and doses are suitable, and how to use them around the time of surgery.

✓ Prescription medicines to support quitting

Prescription medicines for smoking cessation may also be an option for some people. These medicines work on the brain’s response to nicotine and can reduce cravings and withdrawal. They are not suitable for everyone and need careful review of your other medications, mental health history and surgery timing. Always discuss them with your GP and, if they are started, make sure Dr Michael Kernohan and your anaesthetist know you are taking them.

✓ Behavioural and telephone support services

Behavioural support is just as important. Services such as the NSW Quitline, other Australian Quitline services, and local hospital support programs are designed to help people plan, cope with urges and stay on track. Many hospitals in Sydney and Melbourne have written material and links to online tools that you can use between appointments.

Vaping, Nicotine and Surgery

✓ Why vaping still matters when planning surgery

Many people now use e-cigarettes or vapes instead of, or as well as, tobacco. The evidence about vaping and surgery is still developing, but early information suggests that some of the same concerns apply. Vaping can irritate the lungs and airways, and some devices deliver high doses of nicotine, which affects blood vessels and circulation.

✓ Talking honestly about vaping with your team

If you vape, it is important to tell your GP, Dr Michael Kernohan and your anaesthetist. They may advise you to stop vaping before surgery, just as they would with cigarettes. In some cases, switching from vaping to regulated NRT products under medical advice may be part of a plan to step down nicotine and support your lungs. The details will depend on your health, how often you vape, and which substances are used.

The Hospital Environment and the Day of Surgery

✓ Smoke-free hospital policies in Australia

Hospitals in Australia, including those in South West Sydney and Melbourne, are smoke-free environments. This means you will not be able to smoke during your hospital stay. Some patients find this helpful, as it reduces triggers. Others feel worried about cravings. Talking about this before admission allows your team to plan support, such as NRT in the hospital if it is appropriate for you.

✓ What to expect on the day of surgery

On the day of surgery, your anaesthetist and nursing staff will confirm your smoking status, any recent cigarettes or vaping, and whether you are using NRT or other quit medicines. This information is part of planning your anaesthetic care. Even if you have not been able to stop completely, being honest helps the team watch more carefully for breathing or heart issues that may arise.

Staying Smoke-Free After Surgery

✓ Why staying smoke-free still matters after the operation

Stopping smoking before surgery has two benefits. It supports your body during the operation and recovery, and it can act as a starting point for longer-term change. Education materials from health departments in Queensland, NSW and other states stress that it is important not to return to smoking soon after surgery, as smoking again can put stress on your heart, lungs and healing tissues.

✓ Planning for common “high-risk” moments

After your operation, you may be tired, sore and less active. These are times when many people would normally reach for a cigarette. Planning for this in advance can help. Strategies might include arranging support calls from friends or family, keeping NRT products on hand if they have been recommended, avoiding common triggers such as smoking areas, and reminding yourself of the effort you have already made.

✓ Talking about slips without blame

During follow-up appointments in South West Sydney, Dr Michael Kernohan will ask how you are going with smoking or vaping. If you have stayed smoke-free, this can be acknowledged as part of your recovery progress. If there has been a slip, the focus is on support rather than blame. Many people need more than one attempt to stop, and each attempt still builds skills and knowledge for the next try.

A Simple Smoke-Free Surgery Checklist

Three key steps to bring your plan together

A short checklist can help bring your preparation together and can be shared with your GP, Dr Michael Kernohan and your support person:

• Talk with your GP and with Dr Michael Kernohan, Specialist Plastic & Reconstructive Surgeon in South West Sydney, about your smoking or vaping history, agree on a quit date where possible, and decide whether NRT, prescription medicines or referral to a Quitline or clinic are suitable for you.
  
• Plan your home and hospital environment by removing ashtrays and lighters, telling family and friends about your decision, asking smokers not to smoke around you, and discussing how cravings will be handled during your hospital stay and in the early days of recovery.
  
• In the lead-up to surgery and after you go home, use the support tools you have chosen, attend follow-up appointments, stay smoke-free in hospital, and seek extra help from your GP or Quitline if you feel at risk of slipping back into smoking or vaping.

Planning a Smoke-Free Surgery Journey with Dr Kernohan

✓ Reaching out for individualised support

Stopping smoking or vaping before surgery is a serious step, but you do not have to do it on your own. Your GP, local Quit services, and your surgical team all have a role in supporting you. If you would like to talk about how smoking fits into your surgical plan with Dr Michael Kernohan, Specialist Plastic & Reconstructive Surgeon in South West Sydney, you can reach out through the contact page to arrange an appointment and discuss your options in detail.

✓ Starting with an online assessment

Dr Michael Kernohan values patients’ privacy preferences when they choose discreet consultations. If you prefer to begin with an online review, you can use the complimentary photo assessment page to share images and background information. A member of the team will review your details and let you know whether an in-person consultation with Dr Kernohan may be appropriate and what the possible next steps could be.

FAQs on Stopping Smoking Before Surgery

Further Reading

• Read more about Plastic Surgery Risks and Complications
• Read more about Recovery after Cosmetic and Plastic Surgery
• Read more about Facelift Surgery Sydney
• Read more about Upper Eyelid Surgery NSW
• Read more about Neck lift Surgery Sydney
• Read more about Breast Augmentation Sydney
• Facelift Surgery and Lifestyle – Habits That Affect Your Results