Why Can't I Have Neck or Facelift as a Smoker?

Nicotine is constrictor of blood vessels,  decreasing blood flow to tissues that need to flow to heal after surgery. When plastic surgeons do operations that involve longer incisions and/or tissue flaps,  the blood flow to these areas become critical. Without the blood flow ( or a decreased blood flow secondary to the effects of nicotine) healing can be compromised and/or tissue may not survive (tissue necrosis).

For this reason, most plastic surgeons will not operate on patients who smoke within a time period prior to surgery (for specific operations such as facelifting, breast lifting, tummy tuck surgery etc.).

I hope this helps.

When one smokes, or uses tobacco, there is vascular constriction. Nicotine is a major vasoconstrictor. There are others in tobacco as well. Good wound healing is all about getting enough blood supply to the area. In a facelift operation the thickness of the flaps are thin, making the bloodflow even more important. The incision will also be put on some tension. Tension is the enemy of good wound healing, and coupled with decreased blood flow in smokers, finds the patient at higher risk of wound problems. The SMAS facelift technique is excellent, but the surgeon has to work with the tissues given. Our office does not do facelifts on smokers. Some respected colleagues still may do them, but usually the extent of the dissection is less. Please stop smoking, (for dozens of reasons). If the prospect of a facelift is a motivation to quit, then so be it.

   In a face and neck lift the amount of undermining with the impaired blood supply from the smoking puts the patient at risk for skin loss.  Kenneth Hughes, MD Los Angeles, CA