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 A plastic surgeon wants smokers to know: If you light up within a month of a breast lift, your nipples could literally drop off. That’s because smoking can reduce blood flow to some parts of the anatomy. If those body parts don’t get blood, they die, writes Anthony Youn at CNN. He had a patient whose nipples turned purple around the time of her surgery. Youn managed to save the nipples—but his method wasn’t pleasant.

“We went medieval. We used leeches,” Youn writes. The leeches sucked out “old blood” that had been backed up in the woman’s nipples. Now, “in addition to the Surgeon General’s Warning that appears on cigarette packages,” Youn offers “the Plastic Surgeon’s Warning: If you are having a breast lift or reduction and you smoke, your nipples could turn black and fall off.”