In a recent December publication of United Press International, Health Day News reported how two plastic surgeons stated in the Plastic and Reconstructive Surgery December issue how stopping the use of e-cigarettes prior to surgery was highly advised. The doctors highlighted in the piece included Dr. Alan Matarasso of Albert Einstein College of Medicine and Dr. Peter Taub of Mount Sinai Medical Center.
According to Health Day News, the doctors stated, “Based on our current best knowledge, it seems reasonable to advise plastic surgery candidates to cease e-cigarette use,” they said. The doctors continued, “Refraining from [e-cigarette] use four weeks before surgery is a prudent course of action, despite the fact that it has yet to be determined if the effects are similar to traditional cigarettes.”
While the health impacts of “nicotine vapor” continue to be researched, it appears the reason for this medical recommendation underscores patient care. The doctors referred to a study which revealed how stopping traditional smoking three to four weeks prior to a procedure could significantly decrease the risk of postoperative complications.
Blood flow and blood supply is essential following plastic surgery procedures, such as breast surgeries and abdominoplasties. Tissue healing following surgery requires this blood flow.
Erring on the side of caution, it’s believed that e-cigarette users should follow the same protocol as those who use traditional tobacco products. The reason behind this cautionary advice stems from the fact that the side effect of nicotine is best described as a vasoconstrictor.
According to the American College of Surgeons, traditional cigarette smoking does increase complications both during and following surgery. It’s their estimation that following the “no smoking rule” a few weeks prior and after surgery lessens the risk of wound healing by nearly half.
Many plastic surgeons also encompass the cessation of nicotine patches and gum in this medical protocol.
In addition to nicotine, carbon monoxide is also another concern.
While carbon monoxide withdraws oxygen away from the tissue area, as mentioned earlier, nicotine constricts blood vessels which deliver oxygen and nutrients to tissues. Again, this blood flow is vital to the healing process.
If the percentages in oxygen and nutrients drop during the recovery process, there is a risk factor following surgery in areas such as infection, increased chance of scarring, and additional complications.
While some plastic surgeons follow a smoking cessation of four weeks prior and after surgery, others have a more conservative approach of six weeks. A large gap of time is highly recommended and encouraged.
During a patient’s consultation with their plastic surgeon, it’s imperative to be candid regarding any smoking history. And this includes vaping. A surgeon’s top priority is the care of his/her patients and making certain, as a doctor-patient team moving forward, all can be done for an outstanding surgical outcome.
