Postpone Laser Resurfacing and Facelift for Smoker?

I'm due to have Laser resurfacing, upper eyes and a lower Facelift in 1 week. I have smoked 2 cigarettes a day for the last week. Should I postpone my surgery?

For the last 6 weeks, I had cut my smoking from 1 pack to 2-6 cigarettes a day and as I said this last week I've had 2 cigs a day. I hopefully plan on smoking no more prior to surgery.

Doctor Answers 17

Surgery and smoking

You should not smoke before your surgery, particularly before a facelift. Even seemingly little smoking can shrink down blood vessels, reduce blood supply, and can cause terrible scarring or loss of skin. The risk of infection is also higher.

You should be honest with your doctor (I hope you are not my preop patient!) and tell them so they can help you quit.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Smoking and Facelift

YES!  You should stop smoking atleast 2 weeks before surgery.  The longer you stop the better.  Not even 1 cigarette during that timeline.

I would also recommend no nicotine gum or patches as they have similar affects on the blood vessels as does the smoking.

You will have wound healing problems if you continue to smoke and have your surgery.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 77 reviews

Smoking and Facelift

My answer is: yes, you should definitely postpone your surgery. Smoking exposes you to a number of harmful chemicals including nicotine and carbon monoxide. Nicotine acts to shut off blood supply to the tiny vessels that supply your skin and carbon monoxide diminishes your red blood cell's oxygen carrying capacity. The summary of these effects in a Facelift patient who is a smoker: dramatically increased chances of skin loss and hypertrophic (wide scarring) scarring. If you combine your scenario with laser resurfacing, which compounds the trauma to the skin, you are waiting for a disaster to unfold.

You should stop all nicotine products for 6 weeks before and after surgery. In my practice, all smokers are asked to sign a special consent stating that they will agree to comply with smoking cessation.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Quit smoking prior to Fraxel resurfacing

If you are having Fraxel Repair it would be much better to quit smoking first. It is good if you can before Restore, but not as important. We don't have statistics, but I'm sure many people undergoing even Fraxel Repair have smoked and done well, but if there have been complications related to smoking it is not known yet. It is always best, prior to an elective procedure for cosmetic gain, to do whatever you can to ensure a good and healthy outcome.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Lower Facelift and Laser Resurfacing


I would NOT recommend laser resurfacing and facelifting at the same time in a smoker. There is a real risk for skin necrosis ( death of the skin flap) at the site of the incisions.

I also insist that all of my patients that smoke stop smoking 2 weeks prior and 2 weeks after a facelift.

Hope this helps.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 272 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. 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

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 47 reviews

You should listen to your surgeon and do what is recommended

You should listen to your surgeon and do what is recommended.  Smoking is a very real risk and not to be taken lightly.  You may need to delay your procedure or they may have to take a more conservative approach.

Sonia Badreshia-Bansal, MD
Bay Area Dermatologist
3.9 out of 5 stars 12 reviews

Smoking compromises surgical healing

Smoking is a real problem for facelift patients for a couple of reasons. Proper healing requires healthy blood supply and oxygen delivery to the healing tissues, both of which are compromised with smoking.

Nicotine is a vasoconstriction agent that can cut off blood supply to the skin causing the tissue along the incision line to die. This results in very poor healing.

The second issue regarding smoking is that there is a much higher carbon monoxide component in smokers than non-smokers. A higher carbon monoxide component means poor oxygenation in the tissues, which leads to skin necrosis.

Smokers also have a higher infection rate. The best idea is to stop all smoking at least two weeks prior to two weeks after facelift surgery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Never take risks that could be avoided when having plastic surgery

Hi there-

Let's take a big step back from the trees for a minute and look at the forrest...

You are pursuing an improvement in your appearance, on an elective basis...

In other words, it's not as though the operation is necessary to cure you of some disease or prolong your life... in which case the risk of having surgery while still smoking would be more acceptable.

Furthermore, all surgery will have risks, even under the very best of circumstances- and it is ALWAYS in your best interests to make any and all of those risks as low as they can possibly be.

In your case, minimizing your risks means NOT having this type of surgery until you have been off cigarettes completely for some period of time (ask your surgeon what time period they are comfortable with, knowing their preferred technique for your procedures).

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

Smoking Dangerous for Facelift patients

Ask your surgeon, but if you were my patient, I would request that you postpone your surgery. Most experts unanimously agree that smoking increases the risk of most surgical complications significantly. This especially applies to lifting procedures such as the temple 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

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 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.