The nicotine in cigarettes impairs healing and impairs nasal clearance. The nose is highly vascular and usually heals despite factors like smoking. Therefore, being a smoker does not exclude you from having rhinoplasty or septoplasty and you will most likely heal as expected. However, you may prolong your healing period. Studies have shown septoplasty to be less effective in smokers because of the effect the cigarettes have to impede natural clearance of mucous in the nose. I would advise you to quit smoking if possible and to at least not smoke in the first 6 weeks. You should see your surgeon regularly to follow your post-op course.
Had a Septoplasty 1 Week Ago and Had 2 Cigarettes Today, Will This Be a Serious Problem?
Doctor Answers 3
Smoking and surgery
1. There is nicotine in tobacco, but not in marijuana. However, most joints are rolled with marijuana and tobacco combination. Nicotine is a vasoconstrictor that decreases blood flow to the tissues. This is the major problems that can cause a very bad outcome in some surgeries. In a breast augmentation, there is not a lot of risk as there are not a lot of incisions which decrease blood flow to the tissues. In a breast lift or tummy tuck, on the other hand, there is much longer and more involved incisions. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die. This can cause part of the breast or nipple, or in the case of a tummy tuck, part of the belly tissue to die, resulting in a very bad outcome. This is especially bad in breast reductions or face lifts. In a rhinoplasty the tip of the nose and the columella, the area between the tip and the lip, is at risk. Your skin and tissue can turn black and fall off if this happens. In fat transfer, the constricted blood flow can cause the fat to not get a blood supply and die. Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion. Vaporizers do not decrease the amount of nicotine in tobacco, only decrease the smoke. Hookah also does not decrease nicotine.
2. There is carbon monoxide in both tobacco smoke and marijuana smoke. Carbon monoxide decreases the oxygen carrying capacity of hemoglobin in the blood. This is different from the vasoconstrictor effect, but has the same result of having the risk of tissue death in conjunction with surgeries that decrease the blood flow to tissues such as breast lifts and tummy tucks, as opposed to an augmentation alone that does not decrease blood flow to as great of an extent. Again, edible forms of marijuana do not have smoke, and thus carbon monoxide poisoning.
3. Coughing. Both tobacco and marijuana smoke disrupt the lining of the lungs and bronchi and can lead to coughing episodes. Coughing episodes can lead to internal bleeding after surgery that can lead to hematomas and complications, and again a bad outcome. Again, edible forms of marijuana does not have this effect.
4. Anesthesia effects. Marijuana can have drug interactions with certain anesthetic drugs. Thus it is important to tell your anesthesiologist about your marijuana use.
In conclusion, Smoking, whether it be tobacco or marijuana, is detrimental to your surgery outcome. Edible marijuana is much less so, but be honest about your use with your surgeon and anesthesiologist so that you can have the best outcome. In general, you should quite smoking many weeks, ideally 6 weeks before surgery, and not smoke for at least 2 weeks after surgery.
Pablo Prichard, MD
Smoking after septoplasty
In general, you will want to avoid smoking at least 6 weeks before and 6 weeks after surgery. Nicotine itself is a vasoconstrictor. When vasoconstriction takes place, surface area inside the blood vessels decreases. This results in poor blood flow and a rise in blood pressure. In effect, healing is greatly compromised. I would highly recommend refraining from any additional smoking, as it can have a negative impact on your healing. I hope this helps, and I wish you the best of luck with the remainder of your recovery.