I am a smoker and would like to know how long in advance do I need to quit before surgery.

I am 54 years old and would like a lower facelift and neck

Doctor Answers 13


Thank you for your question and concern. I typically ask patients to quit 1 month prior to surgery. However, I have had patients who just can't quit. I have a serious sitdown talk with them letting them know the risk they take by continuing to smoke. The inherent risk is skin tissue loss after the surgery. This is because smoking reduces the amount of blood vessels to the skin and when one does a facelift, you're already lifting the skin and devitalizing the blood vessels already. There are some surgeons out there who will never operate on someone who smokes. However, I have operated on these patients and typically not as aggressive and more conservative with good results. Hope this helps!

Troy Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Smoking and facelift

I like for patients to be off of any form of nicotine for at least one month before and one month after surgery.  That means no patches or gum within a month of surgery.  Those products can certainly be used to help you quit, but will need to be discontinued a month before surgery.  It is certainly worth the effort to quit.  I refuse to operate on active smokers for facelift surgery.  I have seen patients that were operated on by another surgeon while actively smoking and they had significant skin death on their cheeks.  That resulted in permanent scarring and can be disfiguring.  Take the time to quit and no amount of nicotine is safe so don't cheat.

Kenton Schoonover, MD
Wichita Plastic Surgeon
5.0 out of 5 stars 7 reviews

Smoking and surgery

You should quit smoking for at least 3 months before surgery to optimize the chances of your being able to  stay away from smoking  for 6 weeks after surgery, to be conservative.

Renuka Diwan, MD
Cleveland Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Facelift and smoking

depending on the type of facelift and aggressiveness of the surgeon usual recommendations range from 2 to 4 weeks before and after surgery to avoid possible complications of skin loss or severe scarring.

Shahriar Mabourakh, MD, FACS
Sacramento Plastic Surgeon
4.9 out of 5 stars 175 reviews

A smoker and would like to know how long in advance do I need to quit before surgery.

Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts.  Non smiling photos of your face from the front and side would help in the evaluation.  Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.  If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.  If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:

  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face. In smokers the limited dissection associated with this type of SMAS facelift will not carry the same degree of risk as more invasive type facelifts (traditional, deep plane, mid face, extended SMAS and mid face lifts).Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Face Lift and Smoking

You will find different surgeons have different requirements regarding how long to quit smoking before face lift surgery. For my patients, I want them to quit 2 to 4 weeks prior to surgery and not start again for 2 to 4 weeks after surgery. Hopefully if you have quit for that long you won't start again. Smoking is very detrimental for healing. Good luck.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 62 reviews

Quitting smoking

We require patients to be nicotine free of any type (vaping, smokeless, cigarettes, etc) for a month prior to face lift surgery.  Nicotine patches are not safe, either.  I have had many patients quit for surgery, and have remained nicotine free ever since!

Michael Orseck, MD
Greenville Plastic Surgeon
4.9 out of 5 stars 112 reviews

How far in advance to quit smoking before lower face/neck lift?

Different surgeons will have different preferences for how long they like patients to stop smoking before and after a face/neck lift.  My preference is to have patients stop smoking for one month before the procedure and one month after the procedure.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Facelift procedure on a smoker

It's important to stop smoking at least three weeks prior to a facelift and another three weeks after a facelift procedure to allow for optimum healing and prevent skin necrosis. Cigarette smokers have a higher carbon monoxide component in the bloodstream and nicotine both which can contribute to skin necrosis.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

I am a smoker and would like to know how long in advance do I need to quit before surgery.

In our practice we require at least 4 weeks or more of ZERO cigarettes before surgery and the same after surgery. This is to try and prevent major healing problems that may leave terrible scars that cannot be corrected. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 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.