The risks associated with facelifts are rare and usually minor. However, it's always wise to consider the possibility of complications before undergoing any type of surgical procedure. You can reduce your risk of complications by following your surgeon's instructions before and after surgery. Smoking can increase the risks of this procedure since it inhibits blood flow to the skin and can interfere with healing. While it is advisable that patients stop smoking before surgery, the exact amount of time that this needs to be done in order to be safe has not been determined.
Potential complications include:
- Hematomas which are collections of blood under the skin. If small, they may be allowed to absorb spontaneously over several days or a week. If larger, drainage may be required (which may be a needle drainage through the skin or open, surgical drainage).
- Injury to the nerves that control facial muscles is usually only temporary.
- Bleeding and infections are rare possibilities.
- Reactions to the anesthesia can usually be treated medically.
- Poor healing of the skin is most likely to affect people who smoke because nicotine constricts the blood vessels, decreases blood flow to tissues and greatly increases the chance of scarring. It may also occur in people who have very thin skin. It is most likely to occur in the thin skin of the neck behind the ear.
- Skin sloughing is a common complication for facelift patients who smoke. In about 1 out of 10 facelift surgeries on patients who smoke, the patient actually loses a portion of their skin. The most common location for the skin to die is behind the ear but it can happen anywhere that has been undermined by the surgery. The damage is the result of decreased oxygen flow into the skin caused by nicotine and decreased skin oxygen levels caused by carbon monoxide. The risk of skin sloughing can be reduced but not eliminated by stopping smoking for two weeks before surgery. If you smoke and are considering surgery, be sure to tell your surgeon that you smoke, so that he or she can modify the surgical technique to reduce the risk of skin sloughing.
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