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Are Electronic Cigarettes Better For Healing Since They Don't Contain Carbon Monoxide?

I'm trying to quit smoking to help myself heal. Does it do any good to just have 3 a day to wean myself off, or am I wasting my time. Since electronic cigarettes still have nicotine, are they better because they don't contain carbon monoxide?

Doctor Answers (5)

Nicotine is the problem


Most e-cigarettes contain nicotine, and that is the issue with would healing after any lift operation. There are some e-cigarettes without nicotine, but I am not sure they will help with the craving.

It only takes one episode of constriction of the small blood vessels after surgery to interfere with would healing or even cause tissue loss, so even 3 cigarettes a day is really risky. 

Thanks for the question, best wishes.

Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

Nicotine is a bigger problem than carbon monoxide in cigarettes (but neither is good).


Nicotine is such a potent vasoconstrictor that it alone, in even minute quantities (such as second-hand smoke), is sufficient to cause dead skin in breast lift, facelift, tummy tuck, or other flap procedures where skin is cut, lifted, and pulled tighter.

You must stop ALL tobacco use, and any kind of nicotine patch, gum, spray, or e-cigarette containing nicotine. Of course, REAL cigarettes ALSO contain carbon monoxide and other noxious chemicals harmful to your body and healing, so perhaps if nicotine is not quite enough to kill off susceptible skin, then carbon monoxide is like shooting the dead horse "one more time, just to be sure!"

Seriously, you are spending lots of money for elective surgery and presumably want the best result with the lowest likelihood of complications, right? So, STOP smoking right now, including e-cigarettes, or don't waste your money or subject yourself to unnecessary risk. You really don't want dead skin in any area. Neither do we plastic surgeons! Best wishes and good luck with smoking cessation! BTW, Chantix and Zyban are OK during surgery. Ask your doctor for more information if you are serious about quitting. Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 109 reviews

Nicotine increases the risk of complications


Thanks for this great question. One of my patients just asked me this today! I applaud your efforts to stop smoking. This can be very difficult and there are many "stop smoking" aids available. Unfortunately, just like cigarettes, many of them like eCigs, nicotine gum and patches, all have nicotine in them. Nicotine constricts your small blood vessels, the ones that are extremely important to your post-operative healing. I avoid operating on any patient who is actively smoking or actively using nicotine products. 

I encourage you to use this as an incentive to make the final step towards stopping smoking. It's not easy, but you and your body will be safer and healthier if you succeed.

Kara K. Criswell, MD, FACS
Charlotte Plastic Surgeon
4.5 out of 5 stars 13 reviews

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Nicotine no good


If the electronic cigarette provides nicotine, then I would say you have to stop it as well. Nicotine is a vasoconstrictor and not good for healing.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

Nicotine and healing do not mix


In order to give yourself the best chance for proper healing you should be nicotine free for 6 weeks prior to surgery as well as throughout the healing process.  Nicotine is the real culprit since it causes the blood supply to be altered, thus affecting the ability to heal properly.  Any type of nicotine should be avoided- including the patches and gums that aid in quitting smoking but still contain nicotine.  Good luck!

Mennen T. Gallas, MD
Katy Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.