How Soon Before My Facelift Should I Stop Smoking?

Q: How soon should I quit smoking before my facelift? I have smoked for nearly 30 years and I know it has not helped me age well. I think a facelift will really help me look better but I don’t want to have any problems after surgery. On the flip side of that coin, when after my facelift can I start smoking again?

A: There are some things in plastic surgery that don’t go well with it…and smoking is at the top of the list. Besides the obvious deleterious effects on aging that smoking causes, it has its worse effects on skin flap-driven operations. These include facelifts, breast reductions and tummy tucks to name the top three of cosmetic procedures. Because these operations raise long skin flaps that rely on small vessel perfusion from the dermis, anything that impedes or constricts blood flow decreases oxygen delivery to the injured tissues. Without oxygen, survival of healing of the edges of the skin flaps is impaired. It is the carbon monoxide (steals a space on the hemoglobin of red blood cells where oxygen can occupy) and nicotine (causes blood vessel constriction_ which together really hurts tissues from getting what they need to heal.

One should ideally quit three weeks before facelift surgery. If you can’t, and it is important to be honest with your plastuc surgeon, then he or she can modify their facelift technique to lessen the risk of healing problems.

If you are going to invest in a facelift, it makes little sense to keep on smoking.  One should use a major event and expense like a facelift to be the motivation to finally quit smoling.

Dr. Barry Eppley

Indianapolis, Indiana