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Vaping, which is the usage of e-cigarettes, is not only quite popular especially among younger people but is also the most common form of nicotine usage among this group. There is strong evidence showing that it profoundly increases the risks of graduating to real cigarette smoking and even the usage of illicit drugs.

For those who don’t quite know what they are, e-cigarettes are a nicotine delivery system that works by electronically vaporizing a solution that typically contains not only nicotine but also flavorings and other chemicals. Like cigarettes, it can provide a sense of well-being by ultimately affecting the pleasure associated areas of the brain with a positive feedback that can lead to addiction.

In the aerosol are numerous toxic (and possibly carcinogenic) agents that can have both short and long term harmful effects on the lungs. The nicotine stimulates the release of epinephrine in the body which results in an increased heart rate, elevated breathing rate and an elevated blood pressure. It also causes constriction (narrowing) of blood vessels.

So what does this all have to do with Plastic Surgery?

By causing the constriction of blood vessels, nicotine facilitates the reduction of blood flow to tissues leading to both less oxygen and the necessary nutrients that are needed for tissue health and survival. Surgically affected tissues can have an even greater impairment of blood supply with the added physical disruption and division of area blood vessels. Certain procedures, such as a facelift, tummy tuck, breast lift or breast reduction, are impacted to a far greater extent than some other procedures. Compounding this problem is that these same tissues have even greater requirements for oxygen and nutrients in order to facilitate their healing.

With less oxygen and nutrients going to the tissues as a secondary consequence of nicotine usage, there is an elevated risk of such untoward outcomes as infection, delayed healing, wound separation, more prominent scars and necrosis (death) of the tissue which can, in some situations, be disastrous.

These are well known risks and consequences of cigarette smoking and now, as well, of vaping.

This is exactly why it is strongly recommended and even required by the majority of board certified plastic surgeons that you stop smoking and vaping at least two weeks to a month prior to your procedure and not start for at least two to four weeks after it. Even one cigarette or vaping one time in the immediate perioperative period can have dire consequences.

Don’t temp fate – unless you don’t mind having your nipples or breast skin turn black and die (in the case of breast reductions and lifts) or have significant areas of your facial (for facelifts) or abdominal (for tummy tucks) skin turn necrotic – leaving large, unsightly areas of scarring and deformity.

And if that still is not bad enough, your incisions can also fall apart and widely separate, leaving large open, draining and even foul smelling wounds.

So make the right decision regarding stopping smoking and vaping. It is for your own good.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

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