Most facial surgery reduces the blood supply to the tissues. This is especially true with facelifts and blepharoplasties. Nicotine in any form, including cigarettes, other tobacco products, nicotine gum, electronic cigarettes, etc., also reduces blood supply to tissues. The combination markedly increases the risks of the surgery including wound healing, infection and tissue loss. I will not do any facial procedure on anyone who has used any form of nicotine within a month of surgery.