Quitting Smoking Before MACS Lift

I Am Having Macslift in 3 Weeks. I quit smoking 4 months ago. I have been having ONE PUFF of cigarette for last 4 weeks. that is all i have had. Is this ok? I will remain NICOTINE free from now on. My macslift is in 3 weeks.

Doctor Answers 29

Smoking and Facelift

Smoking is a tough habit to kick.  However, smoking has some serious harmful effects including significantly increasing your risk of poor healing, poor scarring, and skin necrosis from cosmetic surgery.  I recommend my patients be tobacco free for at least 4 weeks before surgery.   many surgeons perform a urine cotinine (nicotine) test to make sure the nicotine effects have washed out of your system (and you haven't been sneaking in a smoke here and there).  I always inform my patients that even if you have been smoke free for weeks before your surgery, your history of tobacco use does not disappear.  You will still be at some increased risk for healing problems.  Having said that, stopping smoking before and after surgery (and staying away from 2nd hand smoke) is the best that you can do.  Talk to your surgeon to see what his/her recommendations are.  Best of luck.

Houston Plastic Surgeon
4.7 out of 5 stars 211 reviews

Smoking and surgery

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. 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.
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

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 48 reviews

Quitting smoking before MACS lift

Hello! Thank you for your question! The issue with nicotine is that it also acts as a vasoconstrictor, clamping down of blood vessels. Blood supply is always of great concern during any surgical procedure, but especially in such a procedure as a facelift where the viability of the skin is obviously important. Since the vascularity to the area is already tenuous since it will be raised by cutting around the area, maximizing blood flow to the tissue is critical.

Typically, we recommend at least 6 weeks of smoking cessation prior to and at least 6 weeks after any surgical procedure. The longer, the better. Nicotine always increases the risk for infection, nipple necrosis, poor scarring, and wound complications, as well as other health consequences including blood clots. The anesthesia risk is greater with general anesthesia as well as pulmonary issues/lung infections postoperatively. I would discuss this with your surgeon prior to your procedure. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Quitting Smoking before MACS Lift important

Being completely nicotine free for 4 months is great and significantly decreases your risk of post operative complications. from a MACS lift. One puff in 4 weeks is probably insignificant if in fact this is a true amount. 

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Smoking and lift

Smoking and any kind of lift don’t mix together as the risk of poor healing, scarring, and even loss of skin is dramatically increased.  Having said that you should be OK if you just had 1 puff but i would share that information with your surgeon before surgery

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Smoking dangers with face lifts

I have performed face lifts for over 20 years and here are the issues, IMHO with smoking and a face lift:

  1. The length of smoking and amount dictates your bloods ability to carry oxygen in your red blood cells (RBC). 
  2. Oxygen carried by the RBC's is what's required, after your face lift, to heal the skin and tissues.  If compromised, the skin can die resulting in unsightly scarring.
  3. If you have decreased oxygen carrying capacity, quitting smoking 3-4 weeks ahead of your face lift is unlikely to reverse the damage done and the decreased oxygen carrying capability of your RBC's.
  4. The other issue with smoking and why we ask patients not to smoke for a month before and after surgeris, like face lifts, is the smoke itself that contains components that can displace oxygen molecules from the RBC's further decreasing the ability of the tissues to heal.

 IMHO, patients with a long history (30 or more pack years) or those with known decrease oxygen saturation should not have extensive face lift underming as the risk of skin slough is significant.  The amount of tissue dissection, tightening and removal should similarly be decreased from those with no impairment of their O2 sats.  Smoking after the procedure is also a huge no,no.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

Total abstinence from Nicotine 5 weeks before Facelift is required if not serious problems can occur

Nicotine, even one puff can cause the blood vessels in your facial skin to spasm the result of which can be inadequate blood flow to your skin after a Facelift. This can result is skin loss and very severe scarring.

It is not worth the risk. Even after you stop smoking damage to your blood vessels from years of smoking has set you up for problems.

Don't take chances-re schedule your Facelift until you have no nicotine in any form (including gum) for at least 5 weeks before a Facelift

Smoke free

I ask my patients to quite smoking 8 weeks prior to a surgical procedure. Smoking will increase the risks of post-operative complications. You've come this far, why not just quit? Best of luck!

Michael Sullivan, MD
Columbus Facial Plastic Surgeon
4.9 out of 5 stars 88 reviews

Smoking "just one puff" & facelift

I ask all my facelift patients to be completely nicotine free for 8 weeks prior to a facelift, tummy tuck or breast lift.

 It's well documented that smokers, even those who have 1-2 cigarettes per day, have a significantly increased complication rate.  And since having a facelift is something you're spending your hard-earned money on, it would silly to potentially jeopardize your outcome, for a couple of puffs of a cigarette....

Thomas Fiala, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 80 reviews

Smoking prior to facelift

This is elective cosmetic surgery that you are paying hard earned money for.  You owe it to yourself and your pocketbook to take the appropriate preoperative steps to a safe and healthy recovery.  

If you cannot completely refrain from cigarette smoking for 4 weeks before and after your procedure, you owe it to yourself and surgeon to promptly delay your procedure until you can quit smoking.   It is not worth the risk to your health to take shortcuts in this manner.

I wish you a safe and healthy recovery.

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 87 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.