We've known for decades that cigarette smoking increases cosmetic surgery complications.  But not until this week did we understand that vaping, nicotine patches, and even chewing tobacco increases complications 4 fold!  Across the board in all cosmetic suergery procedures all complications, from infections to bleeding to wound problems are all enormously increased - from 4% to over 15% - in people who use nicotine.  So just don't.  We discuss this, as well as the new CDC report about continued problems of complications and deaths from Americans having cosmetic surgery in other countries.