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Other Complications Caused By Nicotine While tissue necrosis is bad enough, smoking, vaping, and nicotine products can lead to other complications following plastic surgery, including: Blood clots as nicotine affects circulation Infection Delayed or prolonged healing Fat necrosis which causes hard lumps under the skin Permanent blood vessel damage Increased risk of stroke or heart attack How to Quit Smoking Before Your Plastic Surgery Its recommended that you quit smoking, vaping, and using all nicotine products between three and six weeks before your procedure, and you should continue to abstain for up to six weeks after the procedure (though preferably permanently)

New York was one of the first states to ban cigarettes in indoor public spaces in 2003