American Society of Plastic Surgeons (ASPS) members reviewed available research on the possible risks of e-cigarette use in a recent issue of Plastic and Reconstructive Surgery to bring clarity to this hazy area. E-cigarette use, or vaping, has become a popular, and many believe safer, alternative to traditional cigarettes. Still, e-cigarettes have potentially harmful health effects similar to cigarettes and can lead to complications for plastic surgery patients. The biggest concern stems from nicotine, which is a component of many e-cigarettes and reduces blood flow, leading to skin flap complications. Though the team fell short of finding direct evidence connecting e-cigarette vapor with surgical complications, they recommend patients stop vaping at least four weeks before a procedure. Plastic surgeons should also be aware of the possible increase in risk and advise their patients accordingly.