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

Most cautious plastic surgeons will not perform any cosmetic procedure that involves a lot of tissue undermining on a smoker.  These procedures include facelifts, neck lifts, breast lifts, tummy tucks, and breast reductions to name a few.  At my Austin, Texas plastic surgery practice I routinely make patients wait 4-6 week without smoking before having any of the above procedures.  The issue is nicotine which causes constriction of the smallest blood vessels which are needed to heal procedures that have a lot of undermining of tissues.  Failure to quit smoking can lead to devastating results such as open wounds and loss of entire parts of the cheeks or sections of breast/abdomen.  Chantix and smoking cessation programs can help.  Just because you got away with it once doesn’t mean you will be lucky again, so a prudent approach is to stop smoking for at least 4-6 weeks before and after a facelift. 
 

Best of luck,
 

Dr. Kerr.

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

It is absolutely imperative to stop smoking as it causes a much higher risk of complications including skin loss and other wound healing problems. Therefore, I do not operate on patients who smoke unless they have stopped for at least 4 weeks pre-operatively.

As long as you are willing to quite for a few weeks before and after surgery your surgical risks should be acceptable - especially if you have had a good outcome before

A good plastic surgery result relies on good blood flow. The nicotine, carbon monoxide, and hydrogen cyanide in the blood of smokers inhibits their blood's ability to deliver sufficient oxygen to their healing tissues. Thus, patients who smoke are at greater risk of complications and poor wound healing. This is why doctors are hesitant or even unwilling to perform surgery on patients who smoke. Although you are at increased risk for a full face lift, a modified or mini-facelift such as the Lite Lift™ can be performed with less risk than more extensive procedures.