For the past 25 years, I have been a two-pack-a-day smoker.

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Question: For the past 25 years, I have been a two-pack-a-day smoker.  Because of this, I have very deep wrinkles all over my face.  Would you recommend a facial filler to help correct this problem?

Answer: If you have deep wrinkles all over your face, I do not feel that wrinkle fillers are your best option.  By what you describe, it would take multiple syringes of filler to improve upon the number of wrinkles that you have across your face, and this significant amount of added volume will most likely start to look a little full and artificial.  Furthermore, these fillers are temporary and, when patients have a nearly countless number of lines across their face that are deep, I typically recommend laser resurfacing so that the entire surface area of the wrinkled skin can be treated and, with this method, an amazing improvement in the deep wrinkling is possible across large surface areas.

Though the laser resurfacing will provide a significant improvement in the wrinkling of the skin, a laser resurfacing will not improve upon facial laxity and frequently we on performing multiple procedures on patients simultaneously to achieve the expected aesthetic improvement that we desire.  With your history of smoking, you are at increased risk of having problems from a facelift-type surgery and would most likely delay your healing process from a laser resurfacing as well, and I would therefore discuss smoking cessation with you prior to any sort of surgical intervention.

Due to the fact that I perform deep plane facelifts in the operating room setting, I do not consider smoking an absolute contraindication to this surgical procedure, but I would caution you that your risk of having healing problems is going to be significantly increased over a nonsmoking patient.  Ultimately, I recommend a one-on-one personal consultation so that we can discuss your desires and an appropriate customized treatment plan can be created.

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