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

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?

Doctor Answers (36)

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 to heal procedures that have a lot of undermining of tissues.  Failure to quit smoking can lead to devastating results such as open wounds and loss of entire parts of the cheeks or sections of breast/abdomen.  Chantix and smoking cessation programs can help.  Just because you got away with it once doesn’t mean you will be lucky again, so a prudent approach is to stop smoking for at least 4-6 weeks before and after a facelift. 

Best of luck,

Dr. Kerr.

Austin Plastic Surgeon
5.0 out of 5 stars 69 reviews

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
5.0 out of 5 stars 6 reviews

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, FACS
Miami Beach Plastic Surgeon
5.0 out of 5 stars 74 reviews

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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 patients who smoke within a time period prior to surgery (for specific operations such as facelifting, breast lifting, tummy tuck surgery etc.).

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 684 reviews



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
4.5 out of 5 stars 6 reviews

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 through the skin. In a smoker, this circulation is seriously compromised, leading to death of a large area of the skin with a very poor cosmetic result after a long recovery and potentially several operations. 

Peter A Aldea, MD

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 58 reviews

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
5.0 out of 5 stars 47 reviews

Smoking and facelift/necklifts

When one smokes, or uses tobacco, there is vascular constriction. Nicotine is a major vasoconstrictor. There are others in tobacco as well. Good wound healing is all about getting enough blood supply to the area. In a facelift operation the thickness of the flaps are thin, making the bloodflow even more important. The incision will also be put on some tension. Tension is the enemy of good wound healing, and coupled with decreased blood flow in smokers, finds the patient at higher risk of wound problems. The SMAS facelift technique is excellent, but the surgeon has to work with the tissues given. Our office does not do facelifts on smokers. Some respected colleagues still may do them, but usually the extent of the dissection is less. Please stop smoking, (for dozens of reasons). If the prospect of a facelift is a motivation to quit, then so be it.

Jeffrey Roth, MD
Las Vegas Plastic Surgeon
4.5 out of 5 stars 7 reviews

Neck or Facelift in a Smoker


   In a face and neck lift the amount of undermining with the impaired blood supply from the smoking puts the patient at risk for skin loss.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 180 reviews

Smoking & Facelifts


It is absolutely imperative to stop smoking as it causes a much higher risk of complications including skin loss and other wound healing problems. Therefore, I do not operate on patients who smoke unless they have stopped for at least 4 weeks pre-operatively.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 15 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.