All procedures in plastic surgery are performed to improve form and, in some cases, function. Our goal as Plastic Surgeons is to have a perfect form and perfect scars. Unfortunately, smoking and secondary smoke affect wound healing in potentially a very devastating way. Any exposure to smoke either directly or indirectly can result in poor wound healing, delayed wound healing, skin loss necessitating skin grafting, increased risk in wound infection and loss of skin and deeper tissues, all resulting from decreased blood supply to those areas. The diminished blood flow to skin wound edges can cause the breakdown of skin and scabbing. Also, there are well-known increased risks with anesthesia such as increased chance of developing pneumonia. Again, remember that slow wound healing (months instead of weeks), skin loss resulting in scabbing and prolonged need for dressing changes, and infection usually involving the need for antibiotics (but sometimes another surgery to drain the infection) all are complications that can occur at a much higher risk if you smoke or are exposed to smoke (Instead of less than 5%, it can be as high as 60% ). Please be honest with your surgeon so that they can take good care of you and help prevent problems. These are totally elective operations so there is no reason to take any unnecessary risks. If your surgeon tells you smoking is not a problem, I would think twice about your choice of surgeon.