Negative Effects From Smoking the E-Cigarette When Having Facelift?

If a person has quit smoking cigarettes and changed to the e-cigarette which still provides nicotine only. How much negative effects are still present when having a facelift

Doctor Answers 13

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

Phoenix Plastic Surgeon
5.0 out of 5 stars 37 reviews

E cigarette nicotine and facelifts

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.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.5 out of 5 stars 14 reviews

Nicotine and Facelift

   Nicotine can cause skin loss after a facelift, and it should not be used within a week of a facelift or for 6 weeks after.  Kenneth Hughes, MD Los Angeles, CA

Healing ..

The effect of smoking on facelift surgery is more about the blood supply and the ability of the the lifted skin to heal properly. As you maybe aware smoking cigarettes results in an increase in the carbon monoxide level in the blood which deprives tissue of much needed oxygen. Cigarette smoking also affects the fine or smaller blood vessels in the skin which are responsible for healing. Switching to an e-cigarette which as a transition to quitting is actually considerably better choice than smoking as there is no actual smoke being inhaled. Nicotine does not affect healing.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.5 out of 5 stars 56 reviews

Smoking and nicotine

Why are people so tunnel visioned? Smoking or any form of nicotine causes complcations with surgery period period period.

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 20 reviews

Quite smoking before facelift

The rate of complications after facelift surgery in smokers is significantly higher than non smokers. It is the nicotine that impairs blood flow to the skin and whether this is from an e- cigarette, chewing tobacco or gum, it's all the same.  Quite smoking prior to the facelift and give it up for good.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
5.0 out of 5 stars 80 reviews

Smoking & Facelifts

It is absolutely imperative to not be smoking any type of cigarette including e-cigarettes as they have nicotine effects that can adversely effect a facelift. I, personally, do not operate on any patient that smokes because of the negative effects and the increased morbidity. I think it is prudent to have all patients stop smoking for at least 4-6 weeks pre-operatively.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 32 reviews

E cigarette and only nicotine

The nicotine could still restrict your blood flow and could still effect your results. I would try to stop the e cigarette as well before and after your lift for 2 weeks before and after.

Philip Young, MD
Bellevue Facial Plastic Surgeon
3.5 out of 5 stars 44 reviews

Facelift and smoking

Hello, great question.

It's all about the nicotine.  You simply can't have it.  Nicotine is what puts your skin flaps in jeopardy during the healing process. You should approach this as safely as possible in follow your doctors orders very specifically. Do not cut corners and do not cheat as the complications from this can be serious and very stressful for you as the patient.


best of luck


Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Smoking and face lift

I agree with all the comments. And I will add some more. Even if you stop smoking before surgery, the risk of skin necrosis remains. In patient who smoke it is better to do little undermining to reduce the risk of skin flap necrosis. It is also a good idea if the surgeon shows you a picture of skin necrosis in a smoker.

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 13 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.