What is the percentage of dying skin on smokers having a Facelift?

Most surgeon are testing for nicotine because avoiding it is so important in reducing your risk of complications. If you are having trouble maintaining your weight without it I would suggest seeing a weight loss specialist to address ways to manage your weight without nicotine use. Nicotine constricts your blood vessels for about 90 mins so if you smoke a pack per day, that's all day long! Constricting your blood vessels can decrease the healing cells that get to the area as well as antibiotics. 

Most
surgeons won’t operate on patients who smoke for facelift surgery. Smoking
decreases the circulation that can result in necrosis or dying skin.The bottom line is, do not have the facelift
if you can’t quit smoking.

Thank you for ypur question.  The effects of continue on a face lift results in greater then 10X the increase in skin necrosis.  Discontinue smoking for 6 weeks prior to a Facelift. 

You are referring to the feared complication of skin slough after facelift surgery. As you imply, smokers have a significantly higher risk for this problem to arise. The exact risk depends on multiple factors including facelift technique: It can be minimized by using a deep-plane facelift but the risk is still higher than in non-smokers. Numbers found in the literature range from 3% to 20%. 

If you have skin necrosis and slough YOUR incidence is 100%. We know there is a very significantly higher risk in smokers and our best medical advice is to prevent any potential complication you can. Stop smoking! It not only raises the risk of necrosis but slows healing, increases your risk of infection and lung problems. Most facial plastics surgeons will NOT operate on a smoker. Your primary care physician can advise Wellbutrin or Chantix, both of which can be continued during the peri operative period. Nicotine replacement is NOT acceptable.

Regardless of the percentage, if it happens to you it is 100%. Therefore do yourself a favor and stop prior to the procedure. If you can't stop then don't have the procedure. It's not fair to your surgeon to put him or her through that. As surgeons we care about you and your appearance. No one wants to be treating a wound on your face after the procedure. Good luck!

Hard to give exact percentages.  Wound healing problems are more frequent in smokers and most often occur behind the ears.  If you are a smoker, you should be cautioned not to use nicotine patch or gum.  They also cause wound healing problems.  The majority of smokers will have no problems if they stop smoking two weeks ahead of time and don't smoke during the healing process, another two weeks.

Depends on the amount of smoking done over how many years and also on technique.  If a surgeon was to perform a facelift on a smoker, he would necessarily change his technique to avoid this complication by making thicker flaps and undermining less. This can avoid wound healing complications.  

Nicotine powerfully constricts the microcirculation reducing blood flow to the skin.  This can contribute to complications after a  facelift. The most concerning is necrosis of the skin. When portions of the skin die,  healing  occurs by regeneration from underneath. This process usually takes  several weeks to months and often results in some degree of undesirable scarring. Skin necrosis is reported in approximately 2-3% of all facelift cases but is reported to occur as often as 12 times more often in people who smoke. The facelift technique, the amount of permanent compromise to the circulation  and  other health conditions like diabetes can further increase the risks. For this reason, many doctors will not operate on a person who actively smokes. Abstaining from nicotine use  at least 4 weeks prior and a couple weeks after is advised by many surgeons.  It  is always best to consult with your surgeon about your specific risks.  Modified or  alternative treatments may be an option to help reduce the risks.

Hi there. Thank you for the post. It is a really important issue. Smoking increases the risk of virtually all wound healing complications by about 2-3 x. The absolute baseline risk of skin necrosis depends on other factors too (e.g. steroid medication). I would recommend stopping smoking 4 weeks prior to surgery to 4 weeks after - the critical wound healing period. It is one of the few risk factors in your operation that you as the patient can control! Good luck!