Are Smokers Candidates for Lifestyle Lifts?

Doctor Answers 10

Smoking can Result in Serious Complications with ALL Facelifts

Smoking is the single greatest booster of doctors' and undertakers' income. Nicotine (either smoked, chewed or taken in any other way) causes a long standing narrowing of skin circulation. This is associated with a rise in blood pressure and the blood being forced to the muscles away from the skin. As a result, healing from any operation which diminishes blood flow in the skin such as Facelift Tummy Tuck etc is put at great risk. The skin areas at the greatest distance from a blood vessel become blue and die resulting in a scab followed by an ulcer which is followed by a wide ugly scar.

Some surgeons operate on smokers rationalizing that if they not, "someone else" would. Most surgeons who have seen the kind of results obtained on smokers (especially those who are not truthful with their surgeons) would rather have those proverbial "someone elses" take over. It is just not worth it to either an ethical surgeon but especially not to the patient.

Mini-Facelifts such as LS lifts are not immune from smoking complications.

Dr. Peter Aldea

Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Smoking and facelifting

I have performed a large number of face-neck lifting procedures on patients with a past or current history of smoking and tobacco use. I tell all such patients that ideally, they would cut down drastically or stop completely at least two weeks before the procedure in order to decrease the chances of slower healing. The problem with nicotine is that it shrinks the blood vessels to your face. After a Lifestyle-like lift procedure, your body needs as much blood flow as possible to help with the healing. You will heal with nicotine use, but sometimes can have problems with crusting and scabbing. However, I have operated on patients who heal without any problems - as a surgeon you have to be even more meticulous with the procedure and care afterwards.

Gregory J. Vipond, MD, FRCSC
Inland Empire Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

LIfestyle lift and smoking

A lifelstyle lift is a named facelift procedure and should be avoided in smokers because of the increased risks of complications.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

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Smoking and Surgery

As the other Surgeons have correctly noted, smoking is bad for virtually every organ system in the body.  More specifically, smoking causes a constriction of the peripheral blood vessels that supply the skin.  The skin relies on these blood vessels to provide oxygenation in the healing phase after a Facelift.  Secondly, most smokers have a more significant degree of carbon monoxide in their bloodstream, leading to more further impairment in blood supply and oxygenation.

Lifestyle Lift?  That is another story: just read the reviews. Despite many negative reviews, and even patient deaths, the company uses the legal system in an attempt to sue television affiliates (CBS Atlanta: see youtube videos), Surgeons (including me), and other patient advocates (Realself) on the basis of "trademark infringement" and other charges.  This is all performed in the face of Lifestyle Lift employees posting false positive reviews on the internet, which they were fined for by AG Andrew Cuomo in New York.  I would encourage the viewer of these postings to do the Math.

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

Are Smokers Candidates for Lifestyle Lifts?

Smoking can cause excessive bleeding, delayed healing, scarring, just to name a few reasons why smokers can have a significant increase in surgical complications. But I'm sure you have read here on REALSELF that only 45% out of 304 reviews are happy with the LSLift operation - SCARY!!! Seek only boarded plastic surgeons to discuss mini facelifts and smoking, not slick advertising firms, offering the world but only delivering 45% of the time. Be careful out there! From MIAMI Dr. Darryl J. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Facelift and Smoking

Most plastic surgeons regard smoking as a significant risk factor for facelift complication and will not do the procedure.  Modified lifts such as short flap, mini-lift and lifestyle lift type procedures do carry a smaller risk and you may find some surgeons willing to do these.  Your best bet is to quit smoking entirely.

Joseph Campanelli, MD
Portland Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

Smokers and facelifts

A smoker is not a candidate for a facelift until they have been away from all nicotine for at least a month.  Then there is the choice of facelift technique.  Please carefully read the reviews of the LS lift and you will find a great number of unhappy people.  Not so with real facelifts done by real plastic surgeons.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 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

Facelifts in Smokers - which procedure is safest

The good news is that it is possible to have a successful result by a lifting procedure if you are a smoker. The bad news is that your risk of a problem is greatly accelerated. If you are truly unable to stop smoking and all nicotine products then to minimize your risk of a problem, choose the procedure that is the least invasive (i.e. less undermining). I have perfomed several successful procedures using a mini-facelift approach that focuses on rejeuvenating the deeper tissues (SMAS) with minimal undermining, abbreviated incisions and minimal tension on the skin 

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

Smoking can cause serious complications with any type of facelift

Smoking compromises circulation. Patients who smoke are at greatly increased risk of bleeding complications during and after the surgery as well as scarring after surgery. It's possible that patients who smoke can have skin necrosis as well which occurs when the skin actually dies as a result of a lack of adequate blood flow. This can result in permanent scarring and healing delays that can take months to resolve. A lifestyle lift is subject to the same smoking risk as other facelift techniques. I'm sure that you have heard it a million times but for the benefit of your overall health I would quit smoking.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 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.