Smoking can 100% decrease blood flow and circulation. This can lead to necrosis of the facial flap - making the skin near the ears turn black and leathery. I require that all my patients stop all nicotine products for a minimum of 4 weeks before and 8 weeks after surgery. This risk is also given to all my former smokers in writing!
When one smokes, or uses tobacco, there is vascular constriction. 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 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 motavation to quit, then so be it.
