Smoking and all nicotine-containing products will have adverse effects on wound healing. Patients who smoke, use smokeless tobacco, or utilize any nicotine-containing products such as nicotine gum will need to stop before their procedure. Smoking will cause delays in wound healing, wound breakdown, possible skin death (necrosis), and increased risk of infection and scarring. Typically, patients are asked to refrain from nicotine one month prior to their procedure and remain nicotine free for one month after. Many patients find this to be a great excuse to break their habit, with many patients telling the practice that they have quit for good. It should also be noted that patients should remove themselves from environments with “secondhand smoke,” as this can cause similar problems.