Are E-Cigarettes Safe Before Surgery?

e-cigarette2014 has come to a close, and the exploding popularity of e-cigarettes has earned the trend a year-end honor: Oxford Dictionaries Word of the Year is “vape.” According to the Oxford Dictionary, “Vape originated as an abbreviation of vapour or vaporize. The verb means ‘to inhale and exhale the vapour produced by an electronic cigarette or similar device.’”

Electronic cigarettes (e-cigarettes) are plugged as a tobacco alternative and can be an effective smoking cessation device, but “vaping” has rapidly become a culture of its own. It’s assumed e-cigarettes are less hazardous to our health than traditional cigarettes, but in fact the risks are still largely unknown.

So, how does vaping compare to traditional smoking when it comes to cosmetic surgery?

Ditching Cigarettes Before a Procedure

It’s not a secret that cigarettes have no place in a healthy, active lifestyle. But did you know that smoking also negatively impacts plastic surgery results? Most cosmetic surgeons require patients to stop smoking at least six weeks before and after having any procedure. It’s so important to good outcomes that we even test our patients for nicotine before proceeding with surgery.

The biggest risk with smoking before surgery comes from the nicotine content. Nicotine is a chemical stimulant that can contribute to increased health complications before, during, and after surgery. Smoking increases your risk for:

  • Decreased circulation, which causes blood vessels to constrict and prevent blood from flowing freely—the opposite of what patients need to heal properly after surgery. A surgical site with poor blood flow won’t heal as effectively, and the healing process will take significantly longer.
  • Decreased oxygen in the blood caused by the carbon monoxide in tobacco smoke. This makes it more difficult for your heart and body to get the oxygen they need, which can create complications with your breathing during surgery.
  • Reducing efficacy of or negatively interacting with other medications in your system, which can affect your pain management and healing.

For those looking to quit smoking before cosmetic surgery, electronic cigarettes may seem like the perfect tool. But don’t trade your cigarettes for vaping just yet.

Vaping Before Surgery: The Verdict

With the booming popularity of e-cigarettes as a healthier alternative to tobacco, many patients are wondering if they are safe to use prior to surgery. The answer is no.

Although they do not contain tobacco or produce cigarette smoke, e-cigarettes do use a liquid (e-liquid) that contains nicotine, which is inhaled in the form of an aerosol. In addition to nicotine, e-liquids usually contain propylene glycol, vegetable glycerin, and flavorings. Vaping is a safer alternative to burning and inhaling tobacco, but you are still taking in comparable levels of nicotine.

Because nicotine can affect your body’s ability to heal, increase risk of blood clots, and react with medications, e-cigarettes are just as harmful as traditional cigarettes when it comes to cosmetic surgery.

Dr. Pancholi places patient care and safety at the top of his priority list and will not perform surgery on patients who smoke cigarettes, vape with e-cigarettes, or use products that contain nicotine (including gum and patches). If you’ve been considering cosmetic surgery, you’ll want to have great results; therefore we urge you to commit to a cessation plan before scheduling your procedure. If you need help, physician-assisted programs are available.

15 Comments Posted to "Are E-Cigarettes Safe Before Surgery?"

  • August 11, 2016 at 11:57 pm • Posted by Jessica | Reply

    But what if you vape without nicotine? There are plenty of e-liquids without nicotine…

    • August 16, 2016 at 7:00 pm • Posted by Dr. Pancholi | Reply

      Great question. That is true. The effects of nicotine will be absent and that is a good thing.

      That said, you should still abstain from vaping prior to this elective surgery so that your body is primed to have a great surgical result. Anytime a new product is introduced it’s best to follow the precautionary principle because we don’t know everything about the effects of vaping. In my opinion, getting a better outcome from surgery is worth changing some habits ahead of time! — Dr. Pancholi

  • February 23, 2017 at 9:22 am • Posted by Troubled trey | Reply

    How long can nicotine be detected in urine and in blood. I was shot in August and paralyzed from the waist down and have a decubitus ulcer on my tailbone and have to have plastic surgery to plug and close the wound. I have been baking a 3 mg nicotine vape juice but was a smoker for 20 years with a pack a day habit, I am swapping to a 0 mg vape juice today n am due for my appt with the plastic surgeon on the first of March, today is the 23 rd of February and I hope I left enough time to be nicotine free because my Dr told me they won’t operate if there is any nicotine in my system, thank u for answering my question!!

  • April 14, 2017 at 10:18 pm • Posted by Spencer | Reply

    Why a month? Does it matter if it’s a month or like two days? What does the time change?

  • March 9, 2018 at 1:30 am • Posted by Laura | Reply

    Did this get answered? I have the same question!!

  • March 19, 2018 at 9:34 am • Posted by Dr. Pancholi | Reply

    Thank you for your questions.

    Nicotine levels results can show negative results after 24 to 36 hours. Most of these tests are done to you show at that point in time, a safe environment to proceed with surgery.

    The reason we want to wait four to six weeks before and after surgery is to give your body a chance to heal itself from the long-term affects of nicotine. This gives time for recovery from the nicotine damage. It still remains that the oxygen delivered to the tissues is less than ideal, that the platelets are stickier and clot easily.

    Overall we’re trying to optimize healing while minimizing the effects of nicotine that can still be there in 3 to 4 weeks from surgery.

    Stopping for 24-48 hrs may show negative results but does not guarantee healing without issues. Sometimes hyperbaric oxygen treatments can help as well. As a general rule, the less nicotine- the better.

  • April 12, 2018 at 3:25 pm • Posted by Ashley | Reply

    Your post is invalid! You assume with no knowledge on the subject. Yes nicotine is bad for you, but you assumed that all vapor products have nicotine in them which is simply NOT TRUE. You can easily purchase e-liquid with zero Milligrams of nicotine which then leaves behind vegetable glycerin propylene glycol and food grade flavoring, which as far as I know has never been proven to be bad for you, unless you have a allergic reaction to the ingredients which does not happen often. Cigarette companies are very large and dip their paws into a sorts of programs and people because they have a lot of money they can easily do so. Make sure that the information you receive is accurate because cigarette companies often are trying to prove or provide people theories to make vaping seem bad to get people to buy cigarettes instead because vaping has been so successful with getting people off of cigarettes

    • April 16, 2018 at 2:22 pm • Posted by Dr. Pancholi | Reply

      I agree that vaping can exist without nicotine. That is certainly better than vaping products that contain nicotine, particularly when it comes to healing after surgery.

      Speaking to the entirety of safety and vaping is not my intent.

      When it comes to healing after surgery, however, one thing is clear, not vaping is better. Why? The goal is for tissues to receive oxygen so they can heal. Anything that gets in the way of that limits healing. How much it limits healing, hasn’t been studied well enough.

      In regards to the safety of propylene glycol and its history of being used as a food additive, even though ingesting something orally can be safe, it doesn’t mean that it’s safe to inhale. For example, although we can bake with flour or drink coffee, inhaling or vaping flour or coffee grounds would not be good for our lungs. How inhaling proplyene glycol may affect the lungs, again, has not been studied well enough. There haven’t been any unbiased scientific studies preformed showing it’s benefit.

      So, should you vape? Well, if you want to maximize and optimize your conditions for healing, from a purely physiologic stand point, cutting back is a good and stopping altogether is best.

      Dr. Samir Pancholi

  • April 12, 2018 at 3:28 pm • Posted by Ashley | Reply

    And other nicotine products.

  • April 15, 2018 at 10:24 pm • Posted by CDF | Reply

    Hi, I recently got in a car accident (14 broken bones, a collapsed lung, and bruised lung). Would it be safe for me to keep vaping? I had an infected piece of my lung removed (close to 20% removed), my lung has since re-expanded and healed… but again, is it safe for me to vape? Oh and also it’s been about a month and a half since my surgery

  • May 12, 2018 at 10:52 pm • Posted by jessica | Reply

    hello i am getting knee surgery in 2 weeks and i have a vape with 50% nicotine juice in it and hit it often but not everyday. Will the doctors see nicotine in my system? how long will it take for the nicotine to get out of my system if i completely stop?

  • August 8, 2018 at 11:22 am • Posted by Lance | Reply

    Gynocomastia removal in 7 days. They aren’t even giving me 6 weeks. They scheduled me in 7 days. I vape at 3mg and I’m freaking out becuase only 1 week! I know I should stop, i am, but is 7 days going to help me at all?

  • November 13, 2018 at 4:36 pm • Posted by Erin | Reply

    I had vaped prior to two augmentation surgeries. I developed capsular contracture once and I think it’s happening again (5 weeks post op). I didn’t know vaping with nicotine was bad for healing before. If I stop now, could I possibly reverse the hardening of my breasts?

  • December 12, 2018 at 6:07 am • Posted by Christine Batchelder | Reply

    I have e to have spinal fusion surgery in one month and my Dr is going to test me for nicotine. I have smoked for 38 yrs and am having a hard time with it. I started vaping 0mg juice but have had a cig here and there. Will nicotine still show up. And can they test the levels

    • January 2, 2019 at 10:27 am • Posted by Cosmetic Surgery of Las Vegas | Reply

      Hi Christine,

      If you have any nicotine in your system it will show up on a test. Nicotine levels results can show negative results after 24 to 36 hours. Most of these tests are done to show you at that point in time, a safe environment to proceed with surgery. We suggest quitting before surgery.


      Cosmetic Surgery of Las Vegas

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