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Best Facelift Procedure for a Smoker?

I am considering a MACS (short-scar) Facelift or a Deep plane Facelift. Problem is I'm having a hard time kicking my cigarette smoking habit.

I know that most plastic surgeons won't perform a Facelift on a smoker & would like to know the safest Facelift for a smoker, MACS (s-lift) or deep plane? Thank you.

Asked 31 months ago by Babscali in Calif.

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Facelift for smokers

Smokers must stop smoking before and after surgery, period. The risks of large patches of dead skin and permanent scarring are far too great in patients who are actively smoking. In this matter there is little debate. The question is how to deal with a smoker who has temporarily quit smoking for the requisite 4 weeks. I know studies debate this, but I believe there is a significantly higher risk of skin slough (dead skin) even with smokers who have ceased smoking. Therefore in our... more

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Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Best Facelift Procedure for Smoker

The best procedure for a smoker is to quit smoking. We recommend quitting for four weeks before and after surgery. The primary risk is skin loss secondary to compromised circulation. Depending on the patient's age and smoking history, I will do a conservative facelift. These means limited surgery (as a minilift), and therefore limited improvement.

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Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

Best facelift for a smoker is no facelift at all

Since you already know that most plastic surgeons won't do a facelift on a smoker, why do you want to get around that advice and put yourself in harms way? The risk is skin death - the skin turns black and dies and creates unfixable scars. Sorry about being graphic but it sounds like you need to hear the reality behind the advice. In order to reduce your risk but not eliminate it, you need to be away from all nicotine products for at least one month beofore and after surgery, including... more

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

Facelift and Smokers

I'm sure that not one of the physicians will say much more than stop smoking. The risk of skin loss is so high in smokers that doing a facelift on a smoker is a set up for failure. So my impression is that your dissatisfaction with your facial appearance isn't out weighed by your smoking. You'll quit when it is.

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Undermining the skin + smoking = skin loss

Plastic surgeons get nervous performing operations on smokers which involve undermining a lot of skin because cigarette smoking decreases the ability of the body to heal and the blood supply to the skin in numerous ways. That said, we perform operations every day on smokers if the procedure does not involve a great deal of undermining. I do always inform patients, however, that smokers absolutely do not heal as well as non-smokers. There are numerous things you can do to improve your... more

W. Tracy Hankins, MD

Las Vegas Plastic Surgeon

Quit Smoking!!!

I like the mini face lift with minimal flaps for someone whom smokes. There are some doctors whom will operate on smokers and some that will not. I think it is always safest to assume that someone whom smokes will probably continue smoking after surgery and plan the surgery accordingly and do a lesser procedure with thicker flaps and less dissection. I would also think of adding some laser resurfacing secondarily and fillers to enhance the result.

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Charles Perry, MD

Sacramento Plastic Surgeon

ASPS

No facelifts for smokers

Hi, frankly I would strongly advise against any type of facelift if you smoke. The risks of skin necrosis (the skin turns black and sloughs off) and subsequent scarring are very real. If you are planning to spend the time and money for a facelift, it's in your best interest to be smoke-free. I certainly understand that it's difficult to quit smoking, but this will be the best option for you in the long run both for your health and your surgical results. Good luck, /nsn....

Nina S. Naidu, MD

New York Plastic Surgeon

ASPS

Deep plane

The safer of the 2 techniques is a deep plane facelift because less skin elevation is required to lift the face. But ideally being smoke free is the best case scenario.Have you sought professional help to stop smoking? My patients have had success with Welbutrin and there are newer drugs with good short term success rates available. You will need to be smoke free for at least 2 weeks before and 2 weeks after surgery. Although you might do well regardless, it makes sense to control as many... more

Robert W. Kessler, MD

Orange County Plastic Surgeon

ASAPS ASPS

Facelift and smoking do not mix

Smoking is the single most detrimental thing you can do to you face and skin second only to severe sun exposure or photo aging. Twin studies or comparisons have been done to evaluate the aging effect on the skin between a smoking and a non smoking twin and the aging process can be accelerated over 10 years compared to the non smoking twin. Smoking constricts the fine blood vessels in the skin dramatically increasing the risk of poor healing or skin loss after facelift. The best facelift in... more

Peter E. Johnson, MD

Des Plaines Plastic Surgeon

ASAPS ASPS

Facelift for Smokers

None It is not advisable to undergo any kind of facelift. You have a lot of other options available to improve your looks. Botox and filler injections can make a big difference. Especially fillers can be used for doing a 'liquid facelift' My favorite filler for that is Sculptra. In fact I have had patients who were too scared to get a facelift and ended up getting Sculptra and are very happy with the results. If despite all this you end up going forward with smoking, please start Vitamin C... more

Tanveer Janjua, MD

Bedminster Facial Plastic Surgeon

Facelifts and smoking

Hi! I would not do either operation on you if you continue to smoke, because both the MACS and the deep plane facelift involve raising skin flaps which can have a poor blood supply. Only the subperiosteal midface lift done through the mouth raises no flaps.

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Facelift Technique and Smoking

The deep-plane technique has a lower risk for skin flap loss than any other procedure (including MACS lift). I still would not recommend it if you cannot stop...

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Frank P. Fechner, MD

Worcester Facial Plastic Surgeon

Would not recommend surgery

Smoking has the potential to cause significant wound healing complications after any kind of surgery, not just a facelift. In particular because a large area of skin is being lifted off of the underlying tissue, having a good blood supply not compromised by the nicotine in cigarette smoke is critical. In the case of non-elective surgery, for example taking out your gall bladder or tumor surgery, the benefits outweigh the risks and even if a patient won't quit smoking, it is probably... more

Samson Lee, MD

Seattle Facial Plastic Surgeon

You must stop smoking prior to facelift

You must be free of nicotine 8 weeks before a facelift and your surgeon will assess the status of you skin circulation to decide if a facelift is safe.Generally deeper facelitfs such as the SMAS, Deep Plane and others tend to dirupt the blood supply to the skin less than a traditional subcutaneous (beneath the skin) facelift.See before and after photos of facelift.

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Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

My advice is to quit smoking

Smoking can cause serious complications to any major surgery. In the case of a Facelift you risk poor healing and necrosis of the tissue. You may want to investigate thread lifts if you are not willing to cease smoking.

Robert Vitolo, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Facelift for a Smoker: No Thanks

The best thing for an active smoker who refuses to stop smoking is to avoid having a Facelift. The results due to skin loss can be truly horrific and sometimes irreparable. Although I have agreed to perform a Facelift in smokers, it is only in individuals who sign a consent that states they agree to stop smoking for 6 weeks before and 6 weeks after smoking with consent to perform nicotine testing. If a scent of smoke is detected in the preoperative period, the case is... more

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Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

Best Facelift Procedure for a Smoker

There is no best procedure for a smoker. I do not personally operate on patients who smoke because their risk ratio is up to ten fold higher than a non-smoker. I’m not willing to compromise my aesthetic procedure or the aesthetic result in a patient that is not going to stop smoking for at least 6-8 weeks before an operative procedure. My best advice to you is to stop smoking or to not smoke for at least 6-8 weeks. Long term that will serve you well over a span of two years and will... more

Rod J. Rohrich, MD

Dallas Plastic Surgeon

ASAPS ASPS

Face Lift and Smoking

What face lift procedure is best for a smoker? The answer is: no face lift. I agree with previous posts in that there is NO safe face lift for a patient that smokes. I, and most other plastic surgeons in Florida and the United States, would not perform any kind of face lift on a patient that smokes. Patients that smoke are more prone to skin necrosis (i.e skin death), complicated/delayed wound healing, infection, and terrible scarring. I recommend that you stop... more

Jaime Perez MD

Tampa Plastic Surgeon

ASPS

Facelift and Smoking

A deep plane facelift provides a much more robust blood supply to the face and is safer to use in a patient who is a smoker. Smoking should be ceased prior to a facelift if possible. There is at least a twelve times higher risk of skin slough with smokers than non-smokers. Smoking, along with some other conditions such as diabetes, autoimmune disorders, etc must be planned carefully with a surgeon with experience working with these conditions. Serious weight... more

Anil R. Shah, MD

Chicago Facial Plastic Surgeon

Smokers are not good facelift candidates

Hi Babscail, As my colleagues have stated, it is not recommended to have a Facelift while you are still smoking. Cigarette smoke contains a substance called nicotine. Nicotine acts to constrict blood vessels which can decrease blood flow to your tissues. Carbon monoxide is also present in the smoke; it decreases that ability of your blood to transport oxygen. These two factors, coupled with the trauma to the skin during a Facelift, makes for an unacceptably high risk for... more

Lawrence Tong, MD

Toronto Plastic Surgeon

ASAPS ASPS

No Safe Facelift For A Smoker

There is no 'safe' facelift for a smoker. If you are truly looking to improve your facial aesthetic, there is a very real risk of scarring, flap death, and wound healing problems with smokers which is not acceptable for a purely cosmetic surgery. While I don't test patients for tobacco products, I have them agree to stop smoking two weeks before AND two weeks after surgery. If you start soon after surgery, you still run a risk of a poor outcome. You definitely don't want... more

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D.J. Verret, MD

Dallas Facial Plastic Surgeon

No safe facelift for a smoker

There is no safe facelift for a smoker. It is critical that the patient quit smoking prior to an elective cosmetic facelift procedure. The reason for this is the carbon monoxide from cigarette smoke is highly affinitive for red blood cells and basically starves the healing tissues of oxygen. The second component regarding cigarette smoking is the nicotine, which is a vasoconstrictor (constricts blood vessels) that restricts blood flow to the tissues. It is important to stop smoking two... more

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