How does smoking affect healing and scarring after plastic surgery?

I'm a smoker. They (any facial surgeon) say you MUST quit smoking 2-6 weeks before and I'm having a real problem. I went from 20 to 24 cigs. a day down to 2 and still its a problem. Perhaps someone could elaborate on the why and how it effects the healing process, scaring whatever. Thank you.

3 answers to “How does smoking affect healing and...”

A: Smoking and Surgery

Steven H. Williams, MD
By Steven H. Williams, MD - Bay Area Plastic Surgeon

I agree with the answers listed below but would like to elaborate on other issues with smoking. For wound healing there are actually two factors. First - Nicotine causes blood vessel constriction, reducing blood supply to the skin.  When we perform surgery the incisions we leave reduce normal blood flow... more

A: The problem with smoking and facelift surgery is that...

Richard P. Rand, MD
By Richard P. Rand, MD - Seattle Plastic Surgeon

The problem with smoking and facelift surgery is that the nicotine constricts the blood vessels that are critical to keeping your lifted skin alive as you heal from surgery. Inadequate blood flow will lead to skin death, with the skin turning black and sloughing off leaving substantial scars on your face that... more

A: Quit Smoking and Remember, "You're a Puff Away From a Pack a Day!"

Michael A. Persky, MD
By Michael A. Persky, MD - Los Angeles Facial Plastic Surgeon

Smoking is thought to retard wound healing through impairing tissue oxygenation (the good, wound healing fresh air "oxygen"), and relative hypoxia (too low of a level of oxygen) may also cause a sluggish neutrophil response to pathogens (which in English translates to your white blood cells are... more

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