Should I stop smoking before a facelift?
⚠️ After your facelift: watch for these warning signs
If you notice any area of skin around your incisions turning dark, black, or developing an unusual smell after surgery, contact your surgeon immediately. These can be signs of skin necrosis, a serious complication that is more common in people who smoke. Do not wait to see if it improves on its own.
Short answer
Yes, stopping smoking before a facelift is strongly recommended. Smokers have up to 13 times the risk of skin necrosis (tissue death) after a facelift compared to non-smokers, and quitting for at least 4 weeks can significantly reduce that risk. Quitting before surgery may also have lasting health benefits beyond the procedure itself.
What the research shows
Smoking raises serious risks during facelift surgery. A review of studies found that smokers face a 13-fold increased risk of skin necrosis (where skin tissue dies due to poor blood flow) after a facelift compared to non-smokers. [4] Animal studies help explain why: smoking damages the tiny blood vessels that carry oxygen to healing tissue, and those harmful effects get worse the longer someone smokes. The good news is that this damage appears to be reversible. After just two weeks without cigarettes, blood vessel function improved significantly in research models, and at least two weeks of quitting was identified as a necessary period before elective plastic surgery. [5] Four weeks of abstinence was noted as the point where smoking-related complications are meaningfully reduced. [4]
The bigger picture: quitting may save your life
Surgeons routinely ask patients to stop smoking before aesthetic procedures, and this requirement has real consequences beyond the operating room. A systematic review estimated that over a five-year period, smoking cessation before common aesthetic surgeries, including facelift, was linked to roughly 429 lives saved and over $524 million in societal cost savings in the United States. [1] Many patients who quit for surgery do not return to smoking, meaning the health benefits can last well beyond recovery.
What this means for you
If you smoke and are planning a facelift, your surgeon will very likely ask you to stop smoking for at least two to four weeks before your procedure. [4][5] This is not just a formality: it directly affects how well your skin heals and your overall safety during surgery. Be honest with your surgeon about your smoking habits. Some surgeons use a cotinine test (a urine or saliva test) to confirm nicotine has cleared your system before proceeding. [4] Ask your doctor about resources to help you quit, such as nicotine replacement therapy or counseling, so you can go into surgery as safely as possible.
Caveats
Most of the research on smoking and facelift complications comes from observational studies and literature reviews rather than randomized controlled trials, which are difficult to conduct on this topic. [4][5] The exact minimum quit time that is safest may vary depending on your individual health and the specific surgical technique used. Always follow your surgeon's personalized instructions.