2 surgeons referred to nicotine in restricting blood vessels. This confused me, as the popularity for imitation cigarettes is becoming more popular in helping smokers to stop inhaling all the other more dangerous chemicals. Would a surgeon still refuse to perform a facelift on a woman who uses these inhalers but has stopped smoking cigarettes?
Is It the Nicotine Itself That Constricts Blood Vessels?
Doctor Answers 26
Nicotine Is a Vasoconstrictor
Does the nicotine produce vessel constriction?
Nicotine and Surgery
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Nicotine does cause blood vessel constricion
While cutting out all the bad chemicals in cigarettes is certainly more health beneficial than smoking cigarettes, nicotine (whether inhaled or taken as a patch, a pill, or gum) does cause blood vessel constriction, which can effect your results. For cosmetic procedures, most all plastic surgeons will require that you stop smoking at least 3 weeks before and 4 weeks after your procedure. This is because it isn't worth the risk that you will have some wound healing problems. Nicotine causes constriction to tiny blood vessels. Because these are the vessels that we depend on after surgery to get blood supply to your incisions to heal them, they are the most important (more important than the larger vessels in your body that are minimally effected by nicotine). For those smaller blood vessels, the slightest constriction (like that caused by nicotine) can have a huge effect. It's just not worth it. Make sure you've broken away from the nicotine before going under the cosmetic knife.
Does nicotine constrict blood vessels?
Smoking and facelifts
Smoking and 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. 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.
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.
Pablo Prichard, MD
Use of Nicotine Increases Chance of Necrosis, Tissue Loss & Severe Scarring Following Facelift
Skin necrosis, tissue loss and severe scarring, following facelift surgery are devastating problems. The use of nicotine products has been shown to increase the incidence of this complication. For this reason, all types of nicotine should be avoided before and after facial rejuvenation surgery.
Nicotine causes vasoconstriction of blood vessels which results in decreased blood flow to the skin. This results in decreased oxygen delivery to the skin. Any procedure that requires the elevation of skin flaps can be adversely impacted by this phenomenon. For this reason we generally, recommend that patients not use nicotine products for 4 to 6 weeks prior to surgery. This includes cigarettes, Nicorette gum, patches and anything else that contains nicotine.
Nicotine and facelifts
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.