E-cigarettes and facial harmonization

The e-cigarette has come into the HOF office as a new kind of patient: young, calling themselves a "non-smoker", and vaping every day. The question "does this get in the way?" is legitimate, and the short answer is: nicotine does, regardless of the format. This page explains why, what changes in risk, and how to talk about it without a lecture and without pretending it does not matter.

What does nicotine do to tissues?

Nicotine is a vasoconstrictor: it narrows small vessels and reduces blood flow in the skin. In people who use it frequently, tissue perfusion may be reduced, which affects oxygenation, healing, and the response to injury. There are also effects on collagen production and on cells such as fibroblasts, which support the skin, and on the overall quality of collagen.

Electronic devices vary: some deliver nicotine at high concentrations, others none; the composition of the liquids is diverse and not always known. The professional does not need to judge, but does need to ask: do you use nicotine? How often? For how long?

What changes in procedure risk?

In procedures with vascular risk, such as the nasolabial fold and the lips, the professional may consider the patient's perfusion as one more factor in the decision. The topic of necrosis and vascular occlusion is addressed in risks of the nasolabial fold. It cannot be stated that vaping causes necrosis, but nicotine is a factor for poorer perfusion, and that enters the weighing.

How to advise without lecturing

The most effective approach is usually appealing to the patient's interest in the result, not to morality. A patient who comes to HOF wants a beautiful, lasting result; nicotine works against that.

This keeps the patient from hiding the use and gives them an achievable goal. If they cannot pause, record it and reconsider the plan.

Possible service approaches

Each service sets its own policy, at the discretion of the qualified professional, following the rules of their professional council in Brazil. Examples of approaches seen in practice:

1. Recording the use in the medical history, with frequency and duration.
2. Advising a reduction or pause before and after the procedure, without promising a magic interval.
3. Adjusting the plan: smaller volumes, stages, and attention to areas of vascular risk.
4. Explaining the limit of the result: the skin of people who use nicotine tends to be of lower quality.
5. Postponing when other risk factors add up (for example, previous poor healing).
6. Offering support: referring them to a quit program, if the patient wants.

For the classic smoking angle, the reasoning is parallel. The main message does not change: nicotine and good healing do not mix.

What if the patient is young and wants to "prevent"?

Some people seek preventive HOF and vape daily. The conversation can include that a skin routine and nicotine control have an effect on preventing aging, perhaps more than the procedure. That does not lessen the value of the treatment, but it aligns expectations and helps with prioritizing.

It is also worth remembering that vaping can come with other habits (alcohol, low hydration), and a complete medical history helps see the whole picture. For general care before injection, see alcohol after facial harmonization and aspirin before filler.

Harmy in the plan

Harmy helps turn the conversation into something concrete: mark the area, set the volume in ml, and show the projection. For a patient who uses nicotine, the plan can be in smaller stages, and the projection helps explain why. Remember it is an illustrative simulation, not a promise of results, and that the real quality of the skin depends on habits the app does not measure.