I Have a Facelift in 2 Weeks, but I Smoked Half a Pack of Cigarettes Yesterday?

Question

I am not a smoker, but I smoked because of a death in the family, will this ruin my surgery?

Kenneth Hughes, MD · Answer

Smoking within 2 weeks of your facelift may not affect anything.  You should contact your plastic surgeon for additional information, because this issue can be technique and experience dependent.

Vincent N. Zubowicz, MD · Answer

If you smoke no more, there should be no increased risk for your facelift.  Chronic smoking interferes with healing primarily by affecting blood supply to the tissues.

Jeffrey M. Darrow, MD · Answer

Smokers have higher rates of complications after face lifts and as this is an elective procedure, you should be sure you have done everything possible to minimize your potential for problems. Have a frank discussion with your doctor. This does not mean you can't have your surgery, but rather that your doctor may wish to postpone it until your stress level is lower and the cigarettes have had a chance to clear your system.

Sachin S. Parikh, MD · Answer

I am sorry to hear about the death in your family.

	
		Smoking and facelift surgery do not go hand-in-hand and this can really impact the way you heal. With that said, first and foremost is to let your surgeon know immediately
	
		The nicotine in tobacco causes blood vessels to constrict thus limiting the healing of the skin flaps and putting them at risk of excessive bruising and even skin dying. 
	
		There is a study in the Archives of Facial Plastic Surgery that looks at performing facelifts in smokers.  This deep-plane facelift technique decreases the chance of any of these complications in smokers. It is important that your surgeon is facile in peforming this type of facelift. 


	I hope this helps and best of luck

Larry S. Nichter, MD, MS, FACS · Answer

Ask your surgeon, but if you were my patient, I would request that you postpone your surgery not just because of the smoking which is a risk but also because this is a very stressful time for you with the recent death of a loved one.

	. Most experts unanimously agree that smoking increases the risk of most surgical complications significantly. This especially applies to lifting procedures such as the  lift you are scheduled to have done. Just about all plastic surgeons strongly recommend women to stop smoking and all nicotine products well in advance of all plastic surgery and especially lift procedures..  Many plastic surgeons recommend stopping all tobacco products several months prior to surgery.
	Here is the reason why: the nicotine in cigarettes and other tobacco products (including Nicorette gum, patches, etc) is a vasoconstrictor, meaning it makes the Smoking is a significant multiplier of many potential complications following surgery and breast augmentation with implants are no exception. Nicotine from smoking causes blood vessels to constrict ( spasm or  tighten up). Over time, these constricted arteries and capillaries deliver less blood to the tissue which is needed for normal healing. Smokers therefore have an increased incidence of higher likelihood of complications such as tissue sloughing (death by necrosis) and infection.  General complications of surgery such as blood clots, anesthetic problems such as pneumonia are also increased.
	A recent scientific article in the Archives of Internal Medicine indicated that, among all forms of surgery, quitting smoking eight weeks prior was never associated with an increased risk of complications

Shim Ching, MD · Answer

Your risk of complications can be higher after smoking. However, I have done this type of surgery in smokers and they have done very well after surgery. My best advice is to let your surgeon know and he or she can decide whether it is best to wait. He or she can also take the appropriate precautions during your surgery or during your recovery to see that you do well.

Michael I. Echavez, MD · Answer

People who smoke definitely have a higher incidence of complications following facelift surgery. You mentioned that you are not a smoker, but smoked half a pack of cigarettes. Anyone who smokes would be considered a smoker, even if it's just one cigarette. I would definitely check with the surgeon who will be performing your facelift, as each surgeon may have different protocols in regards to when they want their patients to stop smoking before surgery. Your particular surgeon may say that it's fine, or may want to postpone your procedure to a later date.

Pablo Prichard, MD · Answer

Here are the major points of smoking Tobacco or Marijuana before or after surgery:1. There is nicotine in tobacco, but not in marijuana. However, most joints are rolled with marijuana and tobacco combination. Nicotine is a vasoconstrictor that decreases blood flow to the tissues. This is the major problems that can cause a very bad outcome in some surgeries. In a breast augmentation, there is not a lot of risk as there are not a lot of incisions which decrease blood flow to the tissues. In a breast lift or tummy tuck, on the other hand, there is much longer and more involved incisions. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die. This can cause part of the breast or nipple, or in the case of a tummy tuck, part of the belly tissue to die, resulting in a very bad outcome. This is especially bad in breast reductions or face lifts. In a rhinoplasty the tip of the nose and the columella, the area between the tip and the lip, is at risk.  Your skin and tissue can turn black and fall off if this happens. Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion. Vaporizers do not decrease the amount of nicotine in tobacco, only decrease the smoke. Hookah also does not decrease nicotine.2. There is carbon monoxide in both tobacco smoke and marijuana smoke. Carbon monoxide decreases the oxygen carrying capacity of hemoglobin in the blood. This is different from the vasoconstrictor effect, but has the same result of having the risk of tissue death in conjunction with surgeries that decrease the blood flow to tissues such as breast lifts and tummy tucks, as opposed to an augmentation alone that does not decrease blood flow to as great of an extent. Again, edible forms of marijuana do not have smoke, and thus carbon monoxide poisoning.3. Coughing. Both tobacco and marijuana smoke disrupt the lining of the lungs and bronchi and can lead to coughing episodes. Coughing episodes can lead to internal bleeding after surgery that can lead to hematomas and complications, and again a bad outcome. Again, edible forms of marijuana does not have this effect.4. Anesthesia effects. Marijuana can have drug interactions with certain anesthetic drugs. Thus it is important to tell your anesthesiologist about your marijuana use.In conclusion, Smoking, whether it be tobacco or marijuana, is detrimental to your surgery outcome. Edible marijuana is much less so, but be honest about your use with your surgeon and anesthesiologist so that you can have the best outcome. In general, you should quite smoking many weeks, ideally 6 weeks before surgery, and not smoke for at least 2 weeks after surgery.Best wishes,Pablo Prichard, MD

Adam David Lowenstein, MD, FACS · Answer

My recommendation would be to put off your surgery.  Smoking increases the risk of losing skin after your surgery and delay of your surgery is well worth reducing this risk.  This from an experienced facial plastic surgeon who has never had a face lift complication from smoking.  

	Additionally, smoking significantly increases the risks of infection and delayed healing.  All of this is because of the damage and constriction that smoking causes in your small blood vessels which critically aid in healing during plastic surgery.  I'm sorry to hear about the death in your family, but let's not add to the stress and so discuss this with your surgeon and hold off a bit on your operation.

Paul L. Leong, MD, FACS · Answer

Smoking before and after surgery can increase the risk of complications including pneumonia, heart problems and wound infection. It is beneficial for patients to quit smoking as soon as they decide to move forward with surgery and at least one week after surgery to reduce issues and improve recovery. I would discuss this with your doctor prior to surgery so that he/she can determine if moving forward with surgery is the best option for you. Good Luck with your surgery!

I Have a Facelift in 2 Weeks, but I Smoked Half a Pack of Cigarettes Yesterday?

Answers (18)

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