I’ve written about smoking and plastic surgery and even vaping and plastic surgery previously. However, as the use of electronic cigarettes becomes more widespread, we are learning more about the negative consequences associated with vaping.
Vaping Done Properly is Toxic
Last night’s news links six deaths to vaping. Hundreds of people have been sickened, and sadly, most have been previously healthy teens and young adults. Public health officials are trying to pinpoint the chemistry and mechanisms causing vaping-associated pulmonary illness.
Cheaper Is Not Better
Just like Plastic Surgery, when is comes to vaping, cheaper is not better. This applies to cheaper vapes whose batteries explode and bootleg vape cartridges containing toxic pesticides. Counterfeit THC oil is especially toxic as it has been demonstrated to release deadly hydrogen cyanide.
Vaping And Surgery
Since smoking has been around longer than vaping, much more is known about the health problems associated with smoking. When it comes to smoking and surgery, the combination is not good. Higher risks of infection and wound healing problems are associated with smoking. For example, smokers are six times more likely to have wound problems after a facelift.
At first, it was hoped that vaping would have fewer detrimental effects than smoking. We know that smoking causes contraction and injury of the blood vessels in the skin which decreases the perfusion and oxygen delivery needed for wound healing. New evidence shows that vaping also has undesirable consequences. We won’t know what vaping is doing to our bodies for another 40 years, but the chart above may be a good indicator of the future findings.
Vaping and Nicotine
Nicotine, derived from tobacco, is the main addictive ingredient in vaping cartridges. Previous studies have shown that nicotinized electronic cigarettes cause cell damage and inflammation. A recent paper from the University of Pennsylvania School of Medicine explored the effect of the aerosol alone on endothelial function, and the results are frightening.
E-cigarettes Damage Your Blood Vessels
The article showed that a single e-cigarette can be harmful to your blood vessels. The article’s title is a mouthful: Acute Effects of Electronic Cigarette Aerosol Inhalation on Vascular Function Detected at Quantitative MRI. The results were published in the August 20, 2019, issue of the journal Radiology.
Long Term Effects of Vaping
The investigators at Penn concluded that, “Inhaling nicotine-free electronic cigarette aerosol transiently impacted endothelial function in healthy nonsmokers. Further studies are needed to address the potentially adverse long-term effects on vascular health.” Unfortunately, long term effects take a long time to discover. It has taken decades to demonstrate the enormous number of ill effects of smoking tobacco, and yet there are still deniers.
Both smoking and vaping are highly addictive, and both industries target youth to maximize the person-hours of smoking they can capture. Why else would a company offer sour gummy flavored vape juice? Since young people tend to be healthier and have more reserve, the ill effects are harder to detect in this population.
Ironically, the recent industry pivot to offer vaping as a method to stop smoking may attract an older, weaker population, so the problems associated with vaping may become apparent more quickly. However, the fact that so many young people have had dramatic, life-threatening health problems should be a clue that the use of e-cigarettes is hazardous.
Protecting Children From Candy-Coated Vaping
Last year, San Francisco voters upheld a ban on flavored vaping products. Michigan, not California, is the first state to ban flavored e-cigarettes. Last week, Governor Andrew Cuomo banned the sale of flavored electronic cigarettes in New York through an emergency executive action. Even President Trump is proposing a ban on vape flavors. While good intentioned, it will likely have little effect on teen vaping as they can already flavor their own cartridges with readily available dessert tastes.
Banning Vaping Altogether
This summer, San Francisco took the battle a step further when Mayor London Breed signed an ordinance effectively banning e-cigarette sales within the city, despite the fact that Juul is headquartered in SF. Unfortunately, since last year, the number of vapers has more than doubled. Again, the intentions are good; however, people have to want to quit. If we remember prohibition, many people died from unregulated bootleg liquor, and we have already seen deaths from bootleg vape cartridges despite both vaping and marijuana being legal currently.
Plastic Surgery And Vaping
Like most plastic surgeons, I recommend halting all smoking and vaping for four weeks prior to any surgery involving skin flaps like Facelifts, Tummy Tucks and Breast Reductions. Multiple studies have demonstrated that stopping prior to surgery significantly decreases the preoperative risks; moreover, stopping also eliminates a bad habit that accelerates aging. For this reason, many patients remain non-smokers after surgery. Kicking the habit is not easy, but it is definitely worth it.
Whether you are a current smoker, former smoker or non-smoker and are considering plastic surgery, be sure to consult with a Board Certified Plastic Surgeon near you. In the San Francisco Bay Area, call (925) 943-6353 to schedule your private appointment in our Walnut Creek Plastic Surgery Center.
UPDATE 09/17/19 – Seventh vaping related death happened in California today.
UPDATE 09/18/19 – Michigan bans all flavored vaping products.
UPDATE 09/19/19 – Eighth vaping related death happened in Missouri today.
UPDATE 9/24/19 – Ninth vaping related death, the second in Kansas.
UPDATE 9/25/19 – Since this article was published a week ago, hundreds more vaping related injuries have been reported. Where is the FDA action? Cities and states have responded with restrictions designed to protect minors, and more recently adults, from this elective and sometimes deadly habit, but this is the FDA’s primary role. In the name of public safety and disease prevention, the FDA requested that Allergan® stop selling textured breast implants linked to fewer and more treatable injuries which occurred over decades. There have been a greater number of more serious injuries from vaping in the last 6 weeks, where is the recall order?
UPDATE 9/30/19 – 12 to 13 confirmed vaping deaths and 805 cases of lung injury. 77% used both tobacco and THC with 36% vaping only TNC and 16% vaping only tobacco. According to the CDC approximately 70% of lung injured patients said they used “Dank Vapes.” “Dank Vapes” appears to be the leader in a large class of counterfeit brands of vape cartridges with THC. Others labels include TKO, Off White, Moon Rocks, Cookies, Chronic Carts, Mario Carts, Kingpen, California Confidential, Cereal Carts and Supreme G.
UPDATE 10/03/19 – 18 deaths and 1080 hospitalizations.
UPDATE 10/17/19 – 31 deaths and 1300 hospitalizations.