I am smoking 3-4 cigarettes a day and plan to have a neck lift in 5 days. How dangerous is this?

In my experience it's a BAD idea for smokers to have open lifting surgery of the face and neck.  I have never knowingly done a facelift or neck lift on a smoker, and I would not consider doing this operation on an active smoker.  This is not a controversial topic.  NO surgeon worth their salt should operate on a smoker for this procedure in my opinion.  If you like your face, then you should not smoke for 3 months before or after such surgery ideally.  Two months might be a reasonable compromise if your surgeon accepts it.

hello therese hayes To go over some simple, general rules: smokers will need to stop smoking well before their surgery, you may be asked to stop certain medications that may contribute to bleeding. #per-op #smoking

Quitting smoking in general is difficult but quitting before surgery, and continuing to refrain post-surgery, can make dramatic differences to your recovery and is one of the most beneficial changes any patient can make. Giving up the habit is a smart decision no matter what the circumstances are as there are so many positive impacts to your health. It can also significantly decrease the risk of complications for patients during and after surgery. Smokers are forever being inundated with information about the health risks of smoking, however, the benefits to your health by quitting prior to surgery are immediate and substantial.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.

You should call your surgeon  immediately and let him or her know of the situation. Unfortunately for both of you, your surgery will likely have to be postponed. No surgeon, experienced or not, is going to perform any sort of elective cosmetic surgery on somebody smoking. My rule is one month off before and one month off after, at a minimum. Vaping is the same. Cameron Chesnut#RealSelf500 physician 

Thank you for sharing your question.  The effects of smoking on wound healing after surgery has been well documented on this website and I would strongly urge you to inform your surgeon of your cigarette use.  I would counsel you against surgery as at a minimum you will have poor healing incisions and at worst can sustain substantial skin loss.  Hope this helps.

Even if you stop at this moment, the smoking damages the small blood vessels of the body.  These are the nutrient vessels that are essential to help the body heal.  A facelift requires the development of long tissue flaps. Smoking profoundly interferes in the healing of these flaps. Smoking can cause necrosis (death) of the tissues that must heal to make a face lift heal properly.  These ultimately heal but can result in unsightly and unsatisfactory scaring. It takes about 2 years of smoking cessation for the microcirculation to recover. 

Does your doctor know that you are still smoking? At this point, you can be at a higher risk of complication. Doctors have different criteria to stop smoking. I require a 2 1/2 week peroperative window where patients have stopped smoking. Please work with your surgeon on this point.

Hello and thank you for your question. I strongly recommend that you reschedule your surgery for a later date.  I always recommend no nicotine products for 4 weeks before and 4 weeks after surgery. 
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

I would not do a neck lift on a current smoker. No nicotine at all for 3 weeks before and after procedure. The risks just too high. Good Luck!

Thank you for your question. We suggest that patients stop smoking for at least 2 weeks prior to surgery, however, that timeframe may differ based on your surgery. Please review your instructions with your board certified facial plastic surgeon. It is important to refrain from smoking during your recovery. Always work with a board certified facial plastic surgery.
Best wishes,