Question: I’m over 50 and have been thinking about getting a facelift but my girlfriend told me that most doctors wouldn’t do the operation on a smoker. Why would smoking be a problem? Is my friend wrong?
Answer: The nicotine in cigarettes, cigars, electric vapor cigarettes, nicotine patches, and nicotine gum causes vasoconstriction (tightening of the blood vessels) at the surgical site, which results in decreased blood circulation. When the wound site isn’t getting a proper flow of blood, the skin and underlying tissue will likely start to die, requiring additional surgery to remove it. The outcome, deformities or significant scarring
can be devastating. The effects of one cigarette (nicotine) may not be known for several weeks; therefore, patients are fooled into thinking that it didn’t cause injury.
I have operated on smokers in the past, when the surgery was urgent or cancer related and I’ve found the risk for post-operative complications too high. It’s VERY important to be honest with a surgeon about your smoking prior to having surgery, for assistance in quitting (even if only temporarily). My patients, who want to have an elective cosmetic surgery, are required to stop smoking at least 3 weeks prior to a scheduled procedure and for a minimum of 4 weeks after. If quitting smoking isn’t working, it’s very important to contact the surgeon. Delaying surgery until smoking cessation can be achieved, may be one of the best investments someone can make, from both a health and financial prospective. If you can stop prior to surgery, you might just be able to quit for good. Ultimately, you’ll look better and feel better.