Does smoking increase complications of hair transplants?

In a 2009 article written by Dr. David Perez-Meza reflecting upon Dr. Tony Mangubat’s two cases of problems following a hair transplant, the connection between smoking and complications from a hair transplant or any plastic surgery to the face, is significant (see attached article below).

Still a other article mirrors these claims: J Surg Res. 2009 Apr;152(2):224-30. doi: 10.1016/j.jss.2008.02.066. Epub 2008 Mar 31 concluding that: “Nicotine has a limited vasoactive effect in the skin and subcutis unlikely to be explained by smoking, which distinctly decreases tissue blood flow, oxygen tension, and aerobe metabolism independent of smoking status“.

This does not negate the effects of smoking just the direct connection between the causes seen and the presence of nicotine suggesting other causes in the cigarette smoke produce problems in wound healing.