Can smoking cause your skin to turn black after a facelift?

Smoking compromises vascularity to the skin and with operations that significantly reduce the blood supply to the skin smoking may Push it over the edge. Dead skin ultimately turns black.

Hi memstan,The term you are referring to is called skin necrosis.  It will be easier to google this term than skin turning black after facelift.  The better question how does smoking increase your chance of the skin turning black or "dying" (skin necrosis) after a facelift.  Cigarettes have nicotine, as well as e-cigarettes and nicotine patches.  Nicotine as a drug constricts blood vessels.When performing a facelift the thin skin is lifted off the fat.  Normally the skin can be fed from the blood vessels from the fat layer, but in plastic surgery skin is often lifted off of the fat.  This requires the blood flow to go along the skin blood vessels to feed this thin sheet of skin with oxygen and nutrients from the blood vessels.If the nicotine constricts the blood vessels in a chronic smoker, what might happen to the parts of the skin which is furthest from the blood supply.  Typically the areas at risk are the furthest from the where the skin is still attached to the fat.  Another problem area, is if too much skin is removed, and the skin is pulled together with too much tension.  This tension stretches the skin and the skin stretching can further constrict the blood vessels in addition to the nicotine.  In fact too much tension on a skin incision on a non-smoker is also a risk factor for skin necrosis.  Diabetics are also at risk for skin necrosis.  The high blood sugar in diabetics causes poor circulation which leads to necrosis of the toes and fingers and worse.  The small blood vessels have such poor circulation that non-operated fingers and toes simple clot off and die.  When an appendage dies (also necrosis) we will also call that gangrene, or dry gangrene.In order to offer a facelift/necklift to a smoker, it is best for the smoker to quit all nicotine products for 6 weeks before and after surgery for the best healing and reduction in the chance for skin necrosis.  Although the skin necrosis risk does not go as low as non-smoker levels, it is much safer than an actively smoking patient.Additional modifications that a surgeon can do, is to perform a deep plane facelift to keep more fat/tissue connected to the skin and supply the skin with more blood flow.  When trimming the excess skin, it would be safer to trim slightly less skin to make sure there is little to no tension on the skin which may cause physical blood vessel constriction.  Elevating the skin off of the underlying fat shorter distances would also the distance the blood vessels need to carry the oxygen and nutrient shorter and reduce some risk.Good question.  Hopefully your question will help many other nicotine users who are considering a facelift.Best,Dr. Yang

Smoking, or using nicotine in ANY fashion can cause problems with healing after ANY surgery.  This is due to nicotines effect of decreasing the blood flow in the tissues.  Most surgeons will not operate on patients who use nicotine/smokers due to the likely hood of complications.  If contemplating a facelift, have a frank discussion with your doctor.  Most require total avoidance of nicotine products for 3 weeks before and 4 weeks after.

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.

Smoking can cause significant skin loss following facelift surgery and in a published study, skin loss in the post auricular area was 15 times more likely to be loss when patients smoked, than in the non smoking group.  As the other doctors mentioned, nicotine, is part of the problem, but also carbon monoxide and other toxins related to smoking may be more the culprit.  I recommend that patients stop smoking for at least 4 weeks prior to surgery and administer oxygen for 24 hours following the procedure to try to  minimize the risk of skin loss.  I do not perform facelift surgery on patients who are actively smoking.

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.  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

Smoking caused restricted blood flow to the skin which inhibits the delivery of oxygen and severely inhibits the skins ability to heal properly following a facelift. If you have black skin this is a sign that the skin is dead. You need to follow up with your plastic surgeon immediately to have this evaluated. Furthermore, you need to stop smoking immediately.

Thank you for your question. Hopefully you are not a smoker who has "black skin" after a facelift. Dr. Schulman below, explains it well. Nicotine whether from tobacco smoke, nicotine patches, nicotine gum, or smokeless tobacco greatly increases the risk of skin death with not only a facelift but with tummy tuck, breast lift, arm reduction, or any procedure that involves tightening of the skin. It is an absolute requirement that our patients are nicotine free both before and after surgery. Nicotine also cause premature skin aging. Nicotine and UV light (sunlight) are the two main causes of premature skin aging.

Smoking or, more importantly, the nicotine that is associated with smoking, can vasoconstrict the fine blood vessels in the skin and this can lead to healing problems.  In the worst case scenario, portions skin can actual die ("turn black").  An interesting observation that I've had in my career is that when I can get a patient to stop smoking for 2-3 weeks before and after surgery, they rarely return to smoking thereafter.  Accordingly, you get 2 benefits from the surgery:  you look better AND you ceased smoking!  It's extremely important to be honest with your surgeon about your ability to quit---the nicotine can only cause problems with your outcome.  Remember, smoking is not the only issue as nicotine gums and other products can have the same adverse effects.