Facelift Q&A
85%
WORTH IT RATING
"Worth It Rating" shows the % of consumer reviewers that stated the procedure was "Worth It" or not. See more RealSelf Worth It Ratings or Add Your Review
316 Reviews
Faceliftbefore & after photos
View Before and Afters

Average Facelift Cost: $11,225

Learn about Facelift

1,210 people and 808 doctors are talking about Facelift

Get Free Email Updates

Why Can't I Have Neck or Facelift as a Smoker?

asked 4 months ago by firefly5050 in Portland, OR
Latest answer by Sam Naficy, MD
Question viewed 426 times
Tags: candidate, smoking

I've had both upper and lower eye lid surgery, arm reduction and a tummy tuck. I am a smoker and am 51 years old. I've healed fine in all cases. Why can't I have a neck or facelift?

33 answers to Why Can't I Have Neck or Facelift as a Smoker?

+6

Facelift/smoker

Having any surgery and continuing to smoke is a bad idea. The healing process is compromised due to constricting the blood vessels and blood supply. The healing time will be much longer.
David Alessi, MD

Beverly Hills Facial Plastic Surgeon
+2

Smoking and facelift surgery.

Most cautious plastic surgeons will not perform any cosmetic procedure that involves a lot of tissue undermining on a smoker. These procedures include facelifts, neck lifts, breast lifts, tummy tucks, and breast reductions to name a few. At my Austin, Texas plastic surgery practice I routinely make patients wait 4-6 week without smoking before having any of the above procedures. The issue is nicotine which causes constriction of the smallest blood vessels which are needed... more
Mahlon Kerr, MD

Austin Plastic Surgeon
+2

Facelift for Smokers

Whenever you undergo elective surgery, our goals are to ensure your safety and to have great results. Smoking impairs the blood supply to the area of skin that has been dissected or lifted and can potentially compromise your results with skin sloughing or skin necrosis.
Kimberly Lee, MD

Beverly Hills Facial Plastic Surgeon
+2

Smoking and surgery

Nicotine decreases the oxygen to tissues by vasoconstriction and therefore increases the risks of surgery to the areas operated on. You were lucky with your prior surgeries without complication. I would not suggest taking the risk with the facelift.
Jacob Freiman, MD

Miami Beach Plastic Surgeon
+2

Facelifting for Smoker?

Nicotine is constrictor of blood vessels, decreasing blood flow to tissues that need to flow to heal after surgery. When plastic surgeons do operations that involve longer incisions and/or tissue flaps, the blood flow to these areas become critical. Without the blood flow ( or a decreased blood flow secondary to the effects of nicotine) healing can be compromised and/or tissue may not survive (tissue necrosis). For this reason, most plastic surgeons will not operate on... more
Tom J. Pousti, MD

San Diego Plastic Surgeon
+2

Reason why combining Nicotine ( Smoking) and Facelift / Tummy Tucks is a Really Bad Idea

Nicotine causes severe and prolonged narrowing of all blood vessels in the body (resulting in hypertension and a harder working hert). The effect is especially marked in the skin when the blood circulation drops significantly even after a single cigarette smoked or inhaled from a nearby smoker. In operations in which the skin is undermined and lifted widely from the underlying muscles ( Facelift , Tummy Tuck, Breast Lift etc) and then depends critically on a good circulation... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+2

Facelifts and nicotine don't mix

The nicotine in any form constricts the blood flow to the skin and when it is lifted to do a facelift a substantial amount could die and make horrible scar. Don't try to do this!
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Facelift as a smoker

As long as you are willing to quite for a few weeks before and after surgery your surgical risks should be acceptable - especially if you have had a good outcome before
Sam Naficy, MD

Seattle Facial Plastic Surgeon
+1

Smoking negatively affects any surgery

A good plastic surgery result relies on good blood flow. The nicotine, carbon monoxide, and hydrogen cyanide in the blood of smokers inhibits their blood's ability to deliver sufficient oxygen to their healing tissues. Thus, patients who smoke are at greater risk of complications and poor wound healing. This is why doctors are hesitant or even unwilling to perform surgery on patients who smoke. Although you are at increased risk for a full face lift, a modified or mini-facelift such as... more
Larry S. Nichter, MD, MS

Orange County Plastic Surgeon
+1

Why Can't I Have Neck or Facelift as a Smoke

Smoking can affect the blood supply of the skin and can lead to wounds breaking open and poor quality scars. Many plastic surgeons will not do a facelift on an active smoker as the scars on a facelift are harder to hide than the other normally clothed areas you describe. The effects of smoking on an eyelid surgery are less because there is not as much skin separation from the underlying blood supply as there is during a facelift.
Julio Garcia, MD

Las Vegas Plastic Surgeon

lvcosmeticsurgery.com

+1

Smoking is a "No" when having surgery

The nicotine in cigarrettes will constrict blood vessels and possibly lead to skin death and loss. The skin loss can result in an unsatisfactory outcome with delayed healing and excess scarring.
Cory Lawler, MD

Melbourne Plastic Surgeon
+1

Facelifts for Smokers

Two things.....first you got lucky with your previous surgery and may not again. Second a facelift or necklift has thin flaps that do not do well in smokers with regards to healing.
Richard Galitz, MD

Miami Facial Plastic Surgeon
+1

Facelift in smokers

Most plastic surgeons dread performing a facelift in a smoker. The nicotine acts as a vasoconstrictor and may cause impaired blood supply to the skin flap. This can result in loss of skin, delayed healing and terrible scars as a result. Each different surgeon has their own criteria for performing a facelift on a smoker. Many require no smoking for at least two weeks pre op, some won't operate on smokers at all. The worst problem i have had in a smoker was a patient who... more
Ronald J. Edelson, MD

San Diego Plastic Surgeon
+1

Facelift for Smokers

It is possible for you to have a facelift if you smoke. Your excellent recovery from your previous surgeries is a positive sign. Smoking decreases the blood supply to the skin by constricting the vessels, and this makes the healing time longer and also increases your chances for skin loss. Many surgeons will not perform a facelift on a patient who smokes for these reasons. I will perform the face and neck lift but I do much less skin undermining and tightening.... more
Rondi Kathleen Walker, MD

Washington Plastic Surgeon
+1

Smoking and Facial Surgery

To heal well from facelift surgery requires good bloody supply. Smoking hinders/diminishes this blood supply, hence hinders your healing. In worse case scenarios, smoking can increase your risk for delayed healing or skin necrosis. So please listen to your plastic surgeon and get on a smoking cessation program to kick the habit. Best of luck!
C. Bob Basu, MD

Houston Plastic Surgeon
+1

Why smokers shouldn't have facelift

Smoking creates two serious issues with a facelift that are not present in other operations. Smokers have a higher carbon monoxide component in their bloodstream, which preferentially binds to red blood cells so that oxygen cannot get to the tissues. The second component is nicotine, a vasoconstrictor, which further compromises the delivery of oxygen to the tissues. Simply put, the skin around the incision can slough and die due to smoking. This is why most surgeons... more
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Facelifting in Smokers

Several surgeons have given very good explanations why facelifts in smokers are riskier. That is not to say you cannot undergo a facelift. You need to compromise on the expected outcome by reducing the incisions to avoid skin flap healing complications. Additionally, anticipate longer healing times and expect your surgeon to have you stop smoking for a short time before and after surgery. I have done facelifts in carefully selected and motivated smokers for many years. You will probably have... more
Harold J. Kaplan, MD

Los Angeles Facial Plastic Surgeon
+1

Proper Healing for a Smoker

Great question. Although the risks of delayed healing are increased in smokers, conservative minilifts or necklifts may be performed on an individualized basis.
Mark A. Codner, MD

Atlanta Plastic Surgeon
+1

Facelift in a Smoker

As a smoker you can have a facelift, but you are limited in what can be achieved because smoking compromises your circulation and therefore I will not do an extensive lift in which there is an increased risk of necrosis and skin loss. With some patients it is necessary to do long flaps to meet the expectations of both patient and surgeon.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon
+1

Facelift in a smoker

Having a facelift in a smoker is a bad idea. Ther risk of losing a skin flap and severe scarring are increased dramatically. Smoking constricts the small blood vessels in your skin robbing it of oxygen and nutrients. Even under the best conditions, healing is delayed. The flaps in a facelift are very thin, and the skin needs all of the blood supply it can get.
E. Ronald Finger, MD

Savannah Plastic Surgeon

www.fingerandassociates.com

+1

Surgery and Smoking

Smoking can increase inflammation and cause skin healing issues such as skin loss and necrosis (premature death of cells in living tissue). Nicotine can increase the risk of blood clots and it restricts blood vessels that brings oxygenated blood to the tissues. Oxygen helps fight infections and helps keep tissues alive. see video
Miguel Delgado, Jr., MD

San Francisco Plastic Surgeon

www.dr-delgado.com

+1

Why Can't I Have Neck or Facelift as a Smoker?

You can have a facelift/neck lift as a smoker. You must recognize an increased risk of bruising and longer than usual post-operative recovery, as well as possibility of less than optimal scar formation. In such a situation, a scar revision may have to be carried out approximately one year later, with significant improvement. The scars are usually place in the facelift operation in such a way as to be easily camouflaged even if they are more conspicuous than expected. Giving up... more
Kris Conrad, MD

Toronto Facial Plastic Surgeon
+1

Having a facelift and being a smoker is dangerous.

As all the other posts have noted, nicotine and other chemicals in the smoke constrict the blood vessels in your skin. This reduction in skin blood flow can lead to poor healing, poor scarring and possible tissue death. You were lucky to not have problems after your prior surgeries, but these surgeries are different than a facelift, in that some don't have much undermining of the skin , or the flap which is undermined is much thicker than a facelift flap. Safety first,... more
Jeffrey M. Darrow, MD

Boston Plastic Surgeon
+1

Smoking and Facelift

It is not so much that you can't have a facelift as it is this....there is a high likelihood of skin and tissue death when facelift is done in smokers. It is a risk that most plastic surgeon's will not take. It is too high a risk to take for an elective cosmetic surgery. For other cosmetic procedures, it may not be an issue. For facelift, it's a big No-No.
J. Jason Wendel, MD

Nashville Plastic Surgeon

www.mc.vanderbilt.edu

+1

You got away with it before

The answer to your question is that nicotine causes your capillaries to seize up for at least twenty minutes. The thins skin behind your ears in both a facelift and a necklift is very sensitive to nicotine and healing is disproportionately affected by it there. With severely decreased blood flow in the skin the incision won't heal You got away with it on the other surgeries but this is different and you should not risk it. And it is ALL forms of nicotine, including... more
Phillip C. Haeck, MD

Seattle Plastic Surgeon

www.faceliftseattle.com

+1

Smoking impairs healing

Smoking decreases the blood flow to your skin and increases your risks of poor wound healing and blood clots. You also increase your risk of respiratory complications associated with surgery. A facelift is an elective procedure and should be done under the safest circumstances. Thank you for your question. It is important to understand that we as surgeons have your best interest in mind when we request that you quit smoking.
Sarah E. McMillan, MD

Bellevue Plastic Surgeon
+1

Lucky Smoker

I think you will get a sense that having a facelift while smoking is a bad idea. I would bet that every responder will feel the same way on this particular question. Just because you were lucky withe the prior operations does not mean you will be lucky the next time. Nicotine in any form causes a decrease in blood flow and therefore there will be less oxygen to allow the skin to heal properly. This is the case with the tummy tuck as well. A problem scar with a tummy... more
Ralph R. Garramone, MD

Fort Myers Plastic Surgeon
+1

Smoking and surgery

Smoking is bad for facelift procedures. It decreases the circulation to the skin. You put yourself at increased risk of complications. I ask my patients to be smoke free for at least 3 weeks before and after surgery. You may have just been lucky getting away from your other surgery without a problem.
Ronald Schuster, MD

Baltimore Plastic Surgeon

www.drschuster.com

+1

Why Can't I Have Neck or Facelift as a Smoker?

Who says that you can't. Having an extensive long skin flap Face Lift, as a smoker, carries added risk of skin slough but I perform minimally invasive Face Lifts on smokers frequently. Be sure that your Face Lift Surgeon understands and follows the proper aesthetics of facial beauty for the creation of a naturally, more attractive face.
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

Facelift for a Smoker

Nicotine is a powerful constrictor of the microvasculature of the skin. I ask my patients to imagine their lawn sprinkler systems with the water valve in the closed position. With a Facelift, we are raising (to some degree or other based on the type of Facelift) what is described as a "random" flap; random meaning that there is no distinct vascular pedicle, but multiple small peripheral blood vessels that provide blood supply and hence oxygenation to the skin. So... more
Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

www.drprendiville.com

+1

Facelift - Why Can't I Have Neck or Facelift as a Smoker?

It's not that you absolutely can't - just that the risks are significantly higher than for a non-smoker. And there are, in fact, some surgeons who will not perform this procedure on someone's who is smoking, or who will modify the procedure dramatically to account for that. Procedures such as facelifts (also tummy tucks, breast lifts and reductions, etc) rely on the inherent blood supply in order to have successful healing. Smoking reduces that blood supply by... more
Alan Engler, MD

New York Plastic Surgeon
+1

Smoking and facelift.

There is no circumstance in which smoking is okay with a facelift/necklift. As mentioned, this is a powerful constrictor of vessels. This will likely lead to poor healing and significant scarring.
Michael L. Spann, MD

Little Rock Plastic Surgeon
+1

It is not impossible.

The difficultly is that the microcirculation is severely and possibly permanently compromised with the smoking. This can result in necrosis or death of the skin at the edge of the facelift incisions. These do heal but it takes much longer than how people normally heal. Some surgeons address this problem by performing a deep plane facelift to leave the skin together with the SMAS, the connective tissue/muscle plane found below the skin. Does this solve the circulation... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

Ask a question