Smoking and Pilonidal Surgery

Is is absolutely necessary to stop smoking before a cleft lift operation?

When surgeons perform flap procedures for various medical problems, it is a general rule that patients should stop smoking before and after the operation. This is because when a flap is created part of its blood supply is divided in the process of moving the tissue, and the surgeon is then relying on a small group of blood vessels to keep the tissue of the flap alive. Smoking causes blood vessel constriction (vasoconstriction) – in other words the blood vessels become smaller, and can carry less blood – and therefore carry less oxygen to the tissues.

Is this an issue for cleft lift patients?

Fortunately, the skin flap created for a cleft lift has a very, very good blood supply, and vasoconstriction has not been an issue in our patients. If the flaps are created correctly, lack of blood supply is not a problem. So, in our clinic we do not consider smoking a “contraindication” (reason not to proceed) to the surgery.


You should not be smoking. Ever. It is an extremely unhealthy behavior, and this post should absolutely not be viewed as condoning smoking.

However, we also understand that smoking is addictive, and that if a person smokes and has pilonidal disease, they need the same quality treatment that a non-smoker requires, so these are pertinent questions.

But, if you do smoke, maybe this should be a time to look into strategies to quit smoking.

Also, always wear your seatbelt.

Leave a reply