How Does Smoking Affect Healing and Scarring After Plastic Surgery?

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 slowed way down and cannot fight the bad guys, bacteria that cause infection). This also leads to very poor wound healing. Face lift patients have had their cheek skin slough due to poor... more

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 are permanent. The nicotine is the culprit, not the actual smoke so nicotine gums and patches are equally bad. A period away from all nicotine of one month before AND another month... more

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. We count on the remaining blood supply that we haven't cut to keep skin and soft tissue alive. Smoking works directly against this. Second - Smoking also causes small vessel damage (which... more

Much of my objection to smoking has been well covered by the previous answers.  One of the major acute  problems with active smokers is the carbon monoxide affect (from smoking) on oxygen carrying capacity in the blood stream.  This adversely affects recovery on a variety of levels, most specifically wound healing. Therefore, a non-smoking period of at least 2 weeks, but preferably 6 weeks is required. The major chronic problem with smoking is that Nicotine... more