How does smoking affect facelift surgery? Was told to quit smoking 3 wks. prior to surgery. May I 'vape' instead prior?

Thank you for your question, we usually recommend to patients that they stop smoking 4-6 weeks prior to surgery. We do know from research that smoking can lead to poor wound healing and therefore I try to encourage my patients to give up smoking all together.

Hello.  Thank you for your question.  Smoking diminishes the blood supply to the skin which increases the risk of complications and poor wound healing following facelift surgery.  During a facelift, the skin of the face and neck is elevated away from the deeper tissues and associated blood supply, creating a skin flap that depends on blood flow through the smaller vessels within the dermis and and subdermis to provide oxygen to the skin.  In smokers, the blood flow through these small vessels is diminished, resulting in poor oxygenation to the skin skin flap which can result in death of the skin (skin necrosis).  Therefore, it is advisable that patients should stop smoking a minimum of 2 weeks prior to facelift, but even longer is better.  Some surgeons will not perform facelifts on smokers.  I will still perform facelifts on smokers, but I use a short flap technique in those cases to reduce the risk of skin necrosis.  This is a more conservative type of facelift, and can be associated with less dramatic results in patients with significant skin laxity in the face and neck.  I have never had any significant complications with this approach in smokers.  However, they may rarely have small areas of skin necrosis around the edges of the skin flap that may take a while to heal, but generally heal nicely without significant scarring.  Therefore, it is advisable to quit smoking, but there are still facelift options in smokers.  I always advise my patients of the risks and consequences of nicotine use in the perioperative period and strongly advise cessation of all forms of nicotine use prior to surgery.  With regards to "vaping", if there is nicotine being used, it is no better than smoking, in my opinion.  If you are puffing vapor without nicotine, then that should not be a problem.  I strongly encourage you to be absolutely honest with your surgeon about your nicotine use.  I hope this information is helpful.  I wish you the best in achieving your aesthetic goals.

Thank you for your question.Your plastic surgeon gave you good advice not to smoke.  This doesn't mean that you can reach for a substitute as nicotine comes in many forms: gum, patches, snuff, chewing tobacco and e-cigarettes or vaping all have nicotine in common. Mixing nicotine with surgery can cause many problems as it constricts the blood flow, which means less oxygen and less oxygen can cause the tissue to die.  If you must smoke, it's better to delay surgery than to risk potential problems and healing delays.  
Best of luck!Andrew T. Lyos, M.D., FACS

Smoking causes vascular spasm and decreases the blood supply to a particular area. Vasospasm further causes decrease in the tissue healing. Hence it is recommended to stop smoking before any cosmetic surgery for at least a week before & a week after.

With each passing smoke-free day the overall risk of complications lessens. The earlier a smoker can quit, prior to surgery, the better. Even 12 hours prior to surgery, patients have noticed a difference when abstaining from smoking. The ideal period is 8 weeks prior to surgery and quitting smoking for this long will have dramatic effects on your health and recovery.
8 weeks before surgery: the risk of clot related problems decrease (i.e. heart attack and stroke), the body’s immunity will improve which decreases the risk of infection and the response to anaesthetic medications also improves.3 weeks before surgery: the wound healing time is quicker.2 weeks before surgery: less breathing problems will occur during surgery.12 hours before surgery: improved oxygenation, blood pressure and heart rate.In certain cosmetic procedures smoker’s risks are higher and they have lower success rates than non-smokers. Surgeons sometimes refuse to perform procedures—such as relocating blood vessels—as this could put smokers at risk. Tummy tucks, facelifts, breast reduction, use of tissue flaps (in breast reconstruction, for example) fall into this category. A smoker’s cough can disrupt the abdominal healing of a tummy tuck, breast reconstruction complication rates are significantly increased by smoking and after breast reduction, healing of surgical wounds can be impaired. Smokers undergoing facelift procedures face a 13-fold risk of skin necrosis compared to non-smokers. They also face a higher risk of a hematoma (bleeding) after surgery.

Smoking and vaping should be stopped 6 weeks before and 6 weeks after surgery. In general, nicotine will do the following:
Cause vasoconstriciton, impeding blood flow.
Affect the blood supply, and compromise the healing processIt is very important to cut off smoking completely so that you do not compromise your outcome. I would recommend speaking with your surgeon regarding his/her specific guidelines. I hope this information helps, and I wish you the best of luck. 

In addition to its adverse effects on general health, smoking tobacco increases the chance’s of a plastic surgery patient having complications and can negatively affect her results.

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.
A long history of medical studies have shown revealed the risks patients take when they smoke. A 1984 study, which followed 1,100 face lift patients, “found that a smoker was 12.46 times more likely to suffer skin loss than a patient who did not smoke.”
A more recent study in 2003 reviewed 132 abdominoplasty patients. The study “showed wound healing problems in 47.9% of smokers versus 14.8% of non-smokers.”
Whether a plastic surgery candidate smokes or not is a big factor in whether a surgeon will perform surgery on that person or not. At the Pacific Center for Plastic Surgery, patients will be asked about their smoking habits, if any, which will be factored into the doctor’s decisions in her/his case.

Virtually every form of smoking will transiently impair the blood supply to all skin in the body. If one smokes around the time of surgery, the surgeons ability to tighten the skin as much as both the surgeon and the patient would like to see-is impaired.  As a patient, if you would like to optimize your surgical outcome and achieve the best possible surgical result-you would be well advised to stop smoking 6 weeks prior to surgery, and continue this non-smoking status for at least 6 weeks following surgery.   Many experienced Facial Plastic Surgeons will not perform Facelift surgery on any patient who is not willing to stop smoking for this three month perioperative period-WHY??-because we as surgeons want to achieve a home run with your surgery and not a simple base hit.Go for the home run and make it easier for your conscientious Facelift Surgeon !!

Hi there. I generally recommend patients stop smoking 4 weeks prior to surgery and continue to abstain until at least 4 weeks after surgery i.e. during the key healing time! The reason is simple. Smoking increases the risk of all complications by two-threefold - particularly skin necrosis, infection, bleeding and wound gaping! For a simple operation like breast enlargement, it makes less of a difference than facelift. You want to give yourself the best chance of getting a good outcome. The effects of vaping are less clear cut but probably affect outcome in an adviser way too although maybe not to the same extent. Good luck!

Thank you for the question. It is very important to consider the risks to your healing process due to smoking before undergoing an elective procedure such as a facelift. As others have said, there is a higher likelihood of poor healing (necrosis of the skin flaps, particularly around the ears). That said, there are technique related factors as well. In my practice, I perform a deep-plane facelift. Without being overly technical, this procedure does not separate the skin from the deeper muscle/connective tissue layer; rather, the dissection is under this layer, keeping important blood supply intact. As such, the risks to the skin flap, even in smokers, are significantly reduced. In summary, trying to quit would be best. But if you can't, there are still options available.