SMAS Facelift Side Effect True for Smokers?

Any type of facelift surgery, not just SMAS facelift, will have a higher risk of complications when performed on a smoker. Smoking greatly increases the risk of vascular compromise during surgery, which can lead to necrosis (skin death). Smoking also interferes with the body’s healing ability. The best thing to do if you are a smoker who wants a facelift is to quit smoking. If this is impossible, there may be other options available such as a mini-lift instead of a full facelift. In any case, you should stop smoking for at least two weeks both before and after surgery, and you should take care to visit a board-certified facial plastic surgeon who has experience performing surgery on smokers. I hope this helps.

Smoking (or any nicotine product eg patches) doubles your chance of wound healing problems and significantly increases the time of healing if these complications occur, even with deeper plane or SMAS facelifts. You should stop smoking ideally for 6 weeks before surgery to avoid increase complications (minimum 2 weeks).

Hi there, 
If you have already had your facelift procedure and are healing well per your Surgeon's assessment, you need not worry. However, nicotine presence in the body causes vasoconstriction (squeezing tight) of the blood vessels.  When blood isn't flowing abundantly, skin has an incredibly high chance of not healing in the post operative period and in cases involving 'skin flaps' (such as facelift), there is a potential for skin death. Current reccomendation is stoping all nicotine products 4 weeks before and after surgery with no second hand exposure. 

Facelifts in smokers are inherently more risky, regardless of the technique (SMAS, bi-planar, deep plane, etc) that the surgeon uses. There is simply a higher risk of skin loss due to decreased blood flow to the skin. Patients that smoke should quit for at least two weeks before and after surgery in order to improve the chances of skin survival. Additionally, many surgeons (myself included) modify the surgical technique slightly in patients who are smokers. This slightly less aggressive approach is designed to decrease the risk of skin necrosis.
All the best,

Yes, unfortunately, it is true.  The act of smoking is fine but the nicotine and carbon monoxide in cigarettes has a detrimental effect on healing of the skin.  Also, there's an increased risk of scarring, bruising, and infection with smoking.  I recommend that my patients stop 2 weeks before and 2 weeks after the surgery.  Of course, if you can go that long, you might as well quit.  Most people can't go that long and I think recognizing this fact is important.  As a result, we discuss options such as e-cigarettes that can deliver lower doses of nicotine without the carbon monoxide.  I will say that this is also not ideal but if you really want a facelift, and are willing to understand and accept the risk, decreasing your risk by eliminating carbon monoxide during the healing period is a big first step.  The nicotine is still there so your risk of infection, scarring, skin death, and bruising are still there, but hopefully lower.