Before you undergo any surgical procedure, your doctor will no doubt give you a list of pre-op instructions that you must follow for a successful surgical outcome. You may be required to do things like fast for 12 hours prior to surgery, stop taking certain medications, and if you’re a smoker, stop smoking cigarettes for at least four weeks prior to your surgical procedure. The reason patients are asked to stop smoking is because the nicotine found in cigarettes has been found to restrict blood flow, endangering the healing process. But while E-cigarettes have been touted as the safer alternative to traditional cigarettes, new research published in the December issue of the American Society of Plastic Surgeons official medical journal, Plastic and Reconstructive Surgery has found that smoking e-cigarettes or ‘vaping’ may have the same negative effects on healing as traditional cigarettes. We spoke to Dr. Ryan Mitchell of Henderson, NV about these new guidelines.
So, why do surgeons recommend temporarily quitting smoking for four weeks prior to surgery? According to Mitchell, it's due to a very specific problem known as a ‘skin flap’ complication. "A skin flap complication occurs when the nicotine in your bloodstream constricts the blood vessels that are needed to keep your ‘lifted’ skin alive during the healing process. This constriction causes a reduction in blood flow that is known as vasoconstriction," explains Mitchell. Vasoconstriction can not only slow the healing process, but it can also kill the skin, which could turn it black and cause it to fall off, leaving behind significant permanent scars.
But while the dangers of vasoconstriction have been widely known by plastic surgeons for many years, these recent revelations about e-cigarettes may come as a surprise to smokers who consider vaping the safer alternative to smoking. Though vaping doesn’t cause the same damage to lungs as the smoke in traditional cigarettes, their danger lies in fluid ‘vaporized’ in the e-cigarette itself, which contains nicotine. It is because of their nicotine content that plastic surgeons are now recommending those patients who vape follow the same pre-op cessation guidelines as smokers of traditional cigarettes. This comes on the heels of another study by the University of Rochester Medical Center which found that the nicotine in e-cigarette fluid was just as bad for the teeth and cells of the mouth as smoking traditional cigarettes.
As for the recommendation to simply stop smoking for a month, Mitchell understands what a tall order this is. He recommends patients begin reducing their reliance on nicotine products as soon as they think they want a plastic surgery procedure. Says Mitchell "You shouldn’t be smoking in any case, but if you really don’t want to quit for good, at least try to reduce your dependence as soon as you can so you don’t have to deal with the stress of quitting cold turkey." As for patients who think they can get through those four long weeks with nicotine patches or gum, Mitchell says 'think again.' "Because the problem is with the nicotine itself, nicotine patches or gum can cause the same vasoconstriction as smoking or vaping." However, says Mitchell, "One of the benefits of quitting for four weeks is that some patients can quit smoking completely in that time - and never go back following their procedure. The benefits to this are myriad- because not only are you improving your overall health, you’re reducing your risks of premature aging caused by smoking, making your plastic surgery results look better, longer."