# Smoking and Facelift Surgery: Preparing Before You Travel Why smoking matters in a facelift, how long to stay smoke-free before and after surgery, and what changes with vaping, patches and nicotine gum. [Dr. Walter Zamarian Jr.](https://www.walterzamarianjr.com/us/walter-zamarian/) · CRM-PR 17.388 · RQE 15.688 Published October 3, 2026 · Updated October 4, 2026 Topics: [Preparation and recovery](https://www.walterzamarianjr.com/us/blog/category/preparation-and-recovery/) [Read the article ↓](#leitura) ## At a glance: how long before a facelift do I need to stop smoking? In my protocol, the minimum is no smoking for 2 weeks before and 2 weeks after surgery; ideally, 4 weeks before and 4 after. This applies to cigarettes, vaping and nicotine in any other form. The reason is circulation: in a facelift, the skin is lifted from the tissues underneath and needs good blood flow to heal. - Timing: at least 2 weeks before and 2 after; ideally, 4 and 4. - Vaping: counts as smoking; tell me about “nicotine-free” products too. - Patches and gum: they contain nicotine too and follow the same timeline as cigarettes; stopping them is coordinated with whoever prescribed them. - Risk: in a review of 82 studies, smokers had more facelift complications, including skin necrosis and hematoma. - Relapse: tell the team; your surgery date may need to change. - Travel: settle the timing before booking flights to Brazil. My [deep plane facelift](https://www.walterzamarianjr.com/us/face/facelift/) guide explains the operation and how it is planned. Here I cover smoking: why it matters, how long you need to stop and how to prepare before you travel. ## Why smoking matters in a facelift In a facelift, the skin is lifted from the tissues underneath and repositioned; to heal, it depends on the blood that keeps reaching it. Nicotine constricts blood vessels and reduces that flow. The ASPS links smoking to delayed healing, skin loss and tissue necrosis, as well as blood clots and pneumonia [1]. Smoking also matters for anesthesia. The American Society of Anesthesiologists (ASA) recommends quitting as soon as possible and talking to your anesthesiologist about smoking before surgery [2]. ## What the studies show A systematic review and meta-analysis included 82 studies of aesthetic surgery. In facelift patients (10 cohorts), smoking increased the risk of complications, particularly skin necrosis and hematoma [3]. The authors note limitations: studies define “nonsmoker” differently and use different techniques. Another review of nine observational studies of facial surgery found poorer healing in smokers in most of them. The older facelift studies reported the largest differences: in one, from 1984, smokers had about 12 times the odds of skin loss [4]. These are group figures from older techniques; they can’t calculate your personal risk, but they explain why the timeline exists. ## Vaping, patches and nicotine gum Vaping falls under the same rule. The ASPS acknowledges a lack of clinical data specific to e-cigarettes and surgery, but notes that nicotine reduces blood flow and treats vaping and other nicotine products as a risk factor [1]. Switching from cigarettes to a vape doesn’t solve the problem. If a product is labeled “nicotine-free,” tell me about it anyway. Patches and gum contain nicotine too and count, according to the same ASPS reference [1]: they follow the same timeline as cigarettes. Because they are part of a treatment to quit, don’t stop them on your own: we coordinate the transition with the doctor who prescribed them, in time to meet the timeline. ## Preparing before you travel At the consultation, tell me what you use, how often and when you last used it, even if you only smoke occasionally. This isn’t a judgment; it’s the information I need to set the date. Settle the timing before you book nonrefundable flights: if the planned date doesn’t leave enough time, it is better to move the date than to cut the timeline short. According to the ASA, quitting even the day before surgery brings some benefit, but the earlier the better [2]. For an elective operation such as a facelift, that benefit doesn’t replace the timeline in my protocol. If you need help quitting, a smoking-cessation service or your own doctor at home can support you before you travel. After surgery, the timeline continues: at least 2 weeks, preferably 4, without smoking, including after you fly home. Having your stitches out is not a green light to start again. If you relapse, before or after surgery, tell the team. The other preparation timelines are on my [pre-surgical preparation](https://www.walterzamarianjr.com/us/pre-surgical-preparation/) page. ## Frequently asked questions I only smoke occasionally. Do I need to mention it? Yes. Occasional use counts, and the same timeline applies. I quit years ago. Do I still need to tell you? Yes, with the date you stopped. You won’t be assessed as a current smoker, but your history is part of the assessment. Can I switch to vaping until surgery? No. Vaping counts too, and the timeline applies to it. If I meet the timeline, is the risk gone? No. Quitting reduces an important risk, but nothing eliminates the possible complications of surgery. ## Start with the preparation If you are considering a facelift and smoke, or used to, [write to us on WhatsApp](https://www.walterzamarianjr.com/us/contact/): Bruna, my AI assistant, handles the first contact and then puts you in touch with Isanna to arrange a consultation with me. We’ll set the timeline and the date together before you plan your trip. ## References - American Society of Plastic Surgeons. [Managing the Risks of Smoking in Plastic Surgery Patients](https://www.plasticsurgery.org/documents/health-policy/resources/2024-managing-risks-of-smoking.pdf). 2024. - American Society of Anesthesiologists. [Smoking and Anesthesia – Before & After Surgery](https://madeforthismoment.asahq.org/preparing-for-surgery/risks/smoking/). - Bouhadana G, ElHawary H, Alam P, Gilardino MS. [A Procedure and Complication-Specific Assessment of Smoking in Aesthetic Surgery: A Systematic Review and Meta-Analysis](https://pubmed.ncbi.nlm.nih.gov/38433792/). Plast Surg (Oakv). 2024;32(1):115–126. - Chouksey G, Agrawal A, Bhargava S, Karna ST. [Review on the impact of smoking on wound healing following facial procedures](https://pubmed.ncbi.nlm.nih.gov/41787902/). Arch Craniofac Surg. 2026;27(1):1–9. ## About the author I am Dr. Walter Zamarian Jr., a plastic surgeon in Londrina, Brazil. My practice focuses on deep plane facelift surgery with fat grafting. Here I explain my approach, the available evidence, and the limits of each treatment. CRM-PR 17.388 · RQE 15.688 [Read about my training and practice →](https://www.walterzamarianjr.com/us/walter-zamarian/) This article provides general information and does not replace an individual medical consultation. 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