Objective. To study cutaneous microcirculation in smokers and role of laser Doppler flowmetry in risk assessment of trophic abnormalities in adipose-cutaneous flaps of lateral regions of the face and neck during rejuvenation surgery in smokers.

Material and methods. We examined 163 patients aged 25-65 years (50.1±9.1 years) using laser Doppler flowmetry. The control group consisted of 100 untreated patients: 68 non-smokers (their data underlie the database on normal microcirculation in facial and cervical skin) and 32 smokers. The study group included 63 postoperative patients (37 non-smokers and 26 smokers). We analyzed various parameters of microcirculation in adipose-cutaneous flaps of lateral regions of the face and neck. To identify the influence of various regulatory mechanisms, we performed wavelet-transformations of amplitude-frequency analysis of microcirculation oscillations and evaluated oxidative metabolism in tissues. Measurements were performed using the equipment by “Lazma” company in accordance with appropriate guidelines.

Results. We confirmed the negative influence of smoking on cutaneous microcirculation. According to laser Doppler flowmetry data, passive microvascular tone regulation factors compensate this effect at the preoperative stage. However, this process is accompanied by significant decrease in nutritive blood flow and oxidative metabolism. These disorders lead to postoperative trophic abnormalities in adipose-cutaneous flaps of the face and neck.

Conclusion. Negative impact of smoking becomes so critical in postoperative period that cessation of this habit is mandatory after aesthetic surgery.

Keywords. microcirculation, laser Doppler flowmetry, trophic abnormalities, smoking, aesthetic facial surgery