Plastic surgeons encourage their patients to discontinue smoking, and most recommend 4 weeks prior to any plastic surgery. This recommendation is based on the higher complications seen in smokers when undergoing surgery. What isn’t known as well is alternative modes of nicotine consumption (e.g., e-cigarettes). Without studies looking specifically at vaporized nicotine’s effects on skin and soft tissue flaps and more, plastic surgery researchers write in a recent article that the prudent recommendation for plastic surgery candidates is the same made to cigarette smokers: e-cigarette users should refrain from e-cigarette use four weeks prior to surgery.
The authors refer to a study of 102 patients undergoing general surgical procedures. The study showed that stopping smoking for three to four weeks prior to surgery decreased postoperative complication incidence by almost half — from 41% to 21%. Researchers studying colorectal surgery patients didn’t find a similar benefit when the smoking cessation was one to three weeks prior to surgery. Nicotine, according to the authors, has been traced to many post-surgical complications, including skin flap failures. Nicotine can cause elevated blood pressure, which can increase surgical bleeding. It also causes undesired vasoconstriction (narrowing) of important blood vessels that are crucial for optimal wound healing. Another concern specifically related to e- cigarette is an FDA analysis from 2009 that found e-cig cartridges contain other potentially harmful components (e.g., formaldehyde). It is for these reasons, that traditional smoking and by proxy alternative modes of nicotine consumption be discontinued 4 weeks prior to plastic surgery to reduce infection and poor healing risks.
Reference:
http://journals.lww.com/plasreconsurg/Fulltext/2016/12000/E_Cigarettes_and_Potential_Implications_for.38.aspx