Can You Smoke Nicotine-free Electronic Cigarettes Before a Tummy Tuck?

Question

I ordered and started smoking E-cigarettes from Green Smoke in order to quit smoking cigarette's But, after more research I found it was the Nicotine that is bad. So, my question is...if I ordered and started smoking E-cigarettes with Nicotine-free filters (just flavored water vapor) before my surgery, would that be okay?

Richard H. Tholen, MD, FACS · Answer

Though the electronic cigarettes you are asking about have a "nicotine-free" flavor only vapor effect, why must you simulate smoking at all? You already know nicotine is the problem, and "smoking" these e-cigarettes only makes others around you want to light up. Their REAL cigarettes! With real second-hand nicotine!

	Second-hand smoke is just as bad for you as smoking yourself!

	Even 1 cigarette, even exposure to second-hand smoke, even 1 Nicorette gum (you get the idea) can cause enough vasoconstriction that you could end up with a dead belly button, or dead suprapubic skin requiring prolonged dressing changes for an open wound, skin grafts, and additional reconstructive surgery. Forget the cosmetic result--now your surgeon is just trying to get your abdomen healed!

	I do not perform surgery on smokers, as it shows inadequate commitment on the patient's part in obtaining a safe good result. And of course, you know who is expected to "fix things" when these problems develop, even though circulation problems are almost always preventable by compliance with NO SMOKING requirements!

	If your surgeon asked you on the morning of surgery "Is it OK if I don't do my best work today? I can't seem to focus on the important things about your case; it's too hard" would you cheerfully go ahead? That, dear lady, is what you just asked--and you already know the answer! One more example, just in case I am being too obtuse. If your teenage daughter asked you if it was OK to have "pretend sex" with her boyfriend, what would your answer be?

	Truly, I'm not trying to be mean or rude, but even though nicotine-free flavor-vapor electronic cigarettes may be "technically" safe, the risks of second-hand smoke, or simply falling off the wagon are too great, and you really don't want dead skin or belly button! Honest! You may wish to consider Zyban or Chantix--ask your doctor and good luck!

Jerome Edelstein, MD · Answer

Smoking is very detrimental to the recovery process following surgery. It compromises your immune system making your body less effective in fighting infection. It also hinders circulation making the recovery process slower. I usually recommend my patients stop smoking about four weeks before surgery. You should avoid e-cigarettes as well. Better safe than sorry!

Jon M. Grazer, MD, MPH, FACS · Answer

Smoking is BAD for your health period, and even worse when considering surgery. The nicotine in cigarettes clamps down the blood vessels and and there is less oxygen in the blood. With  the decrease in blood flow, there is an increased risk of the skin dying in the area of surgery.

	E-cigarettes are better, in that you do not have the carbon monoxide from the smoke, but you still have the nicotine. Nicorette or nicotine lozenges are not good either, as they have nicotine in them.

	If your E-cigarettes have only water vapor in them then that should be fine, but make sure  there are no other ingredients that may be problematic.

	Take home message : SMOKING and surgery together are bad.

Edward J. Bednar, MD · Answer

At this point I would recommend not to smoke those cigarettes as we really don't know what they are comprised of-i.e are there any ingredients that can cause bleeding etc.. I would avoid them -it' definitely not worth jeopardizing your long term result

Pablo Prichard, MD · Answer

Here are the major points of smoking Tobacco or Marijuana before or after surgery:1. There is nicotine in tobacco, but not in marijuana. However, most joints are rolled with marijuana and tobacco combination. Nicotine is a vasoconstrictor that decreases blood flow to the tissues. This is the major problems that can cause a very bad outcome in some surgeries. In a breast augmentation, there is not a lot of risk as there are not a lot of incisions which decrease blood flow to the tissues. In a breast lift or tummy tuck, on the other hand, there is much longer and more involved incisions. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die. This can cause part of the breast or nipple, or in the case of a tummy tuck, part of the belly tissue to die, resulting in a very bad outcome. This is especially bad in breast reductions or face lifts. In a rhinoplasty the tip of the nose and the columella, the area between the tip and the lip, is at risk.  Your skin and tissue can turn black and fall off if this happens. Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion. Vaporizers do not decrease the amount of nicotine in tobacco, only decrease the smoke. Hookah also does not decrease nicotine.2. There is carbon monoxide in both tobacco smoke and marijuana smoke. Carbon monoxide decreases the oxygen carrying capacity of hemoglobin in the blood. This is different from the vasoconstrictor effect, but has the same result of having the risk of tissue death in conjunction with surgeries that decrease the blood flow to tissues such as breast lifts and tummy tucks, as opposed to an augmentation alone that does not decrease blood flow to as great of an extent. Again, edible forms of marijuana do not have smoke, and thus carbon monoxide poisoning.3. Coughing. Both tobacco and marijuana smoke disrupt the lining of the lungs and bronchi and can lead to coughing episodes. Coughing episodes can lead to internal bleeding after surgery that can lead to hematomas and complications, and again a bad outcome. Again, edible forms of marijuana does not have this effect.4. Anesthesia effects. Marijuana can have drug interactions with certain anesthetic drugs. Thus it is important to tell your anesthesiologist about your marijuana use.In conclusion, Smoking, whether it be tobacco or marijuana, is detrimental to your surgery outcome. Edible marijuana is much less so, but be honest about your use with your surgeon and anesthesiologist so that you can have the best outcome. In general, you should quite smoking many weeks, ideally 6 weeks before surgery, and not smoke for at least 2 weeks after surgery.Best wishes,Pablo Prichard, MD

Sanjiv Kayastha, MD · Answer

I don't know what chemicals are in the E-cigarettes you mention. In general when we don't know every single substance in a medication like herbal dietary supplements the best advice is to avoid them all together. Your health and outcome from surgery are too important to take chances.

Vincent D. Lepore, MD (retired) · Answer

Although, smoking E-cigarettes with a "nicotine-free filter" is probably better than smoking real cigarettes around the time of you tummy tuck surgery, I would suggest you don't smoke anything at all. Even though the manufacturer claims these filters are nicotine free, if these cigarettes do anything to alleviate the cravings, they must deliver some nicotine to your blood stream. Any amount of nicotine or other chemical found in normal cigarette smoke can and does cause vasoconstriction (spasm and narrowing of the blood vessels) in the skin and other tissues and can result in serious wound healing problems. Don't smoke!

Can You Smoke Nicotine-free Electronic Cigarettes Before a Tummy Tuck?

Answers (7)

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