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 recommendation, according to the authors, seems reasonable until more definitive research shows, for example, that e-cigarettes impact skin and soft tissue differently than traditional nicotine inhalation compounds.
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.
While evidence suggests e-cigarettes, a tar-less alternative, might be safer than traditional cigarettes, e-cigarettes contain nicotine, and the amount of nicotine delivered can be different among e- cigarette devices. Nicotine, according to the authors, has been traced to many post-surgical complications, including skin flap failures. Another concern specifically related to e- cigarette is an FDA analysis from 2009 that found e-cig cartridges contain other potentially harmful components.
E- cigarette use is on the rise. Fortune.com reported in 2014 that the then $1.5 billion e-cig market was projected to grow 24.2% a year through 2018.