Skin Necrosis
Skin-edge healing problems, strongly linked to smoking.
What is skin necrosis?
Skin necrosis means an area of skin — usually at a wound edge, often behind the ear — does not get enough blood supply to heal and breaks down. Minor cases heal with dressings over time, occasionally leaving a scar that may need later revision; significant necrosis is uncommon.
The smoking link
Smoking is by far the biggest risk factor for skin necrosis because it constricts the small vessels that supply healing skin. This is why most surgeons insist you stop for several weeks before and after surgery, and may decline to operate on active smokers.
Reducing the risk
Stopping smoking, good diabetic control, careful surgical technique that protects blood supply, and avoiding excessive skin tension all reduce the risk — another reason modern lifts place tension on the SMAS rather than the skin.