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Smoking a Little Bit a Week Before Closed Rhinoplasty?

I am 1 week pre-op and yesterday I smoked a blunt- marijuana wrapped in a tobacco leaf. I've stayed away from tobacco for 2 weeks pre-op (I was a very light smoker, anyway). Would this one slip effect the surgery very much? I'm 18 and healthy otherwise.

Doctor Answers (4)

Hmmm

+2

Smoking is strictly prohibited in cases where flaps are raised such as facelifts and MOHS reconstruction with flaps.  Open Rhinoplasty also places the columella skin at greater risk in smokers.  But the nose is very vascular and usually its not an issue.  Just talk to your doctor and make sure he knows all the facts.


Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 41 reviews

Smoking and surgery

+1
Here are the major points of smoking Tobacco or Marijuana before or after 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.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 28 reviews

Will any tobacco smoke or smoking cause problems or interfere with results of surgery

+1

Any smoking can effect surgery in the 4 weeks prior to the procedure. Will it effect your particular procedure specifically. It will likely compromise some blood supply and it may interfere with  your recovery from anesthetics but ut us impossible to know if it will cause you to have a complication. That is similar to predicting if someone will get into an accident after they have two alcoholic drinks and then get into a car. You know their driving will be impaired but they may not necessarily get into an crash. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

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Smoking before Rhinoplasty Surgery

+1

I will never condone smoking, but this one "slip" 2 weeks before rhinoplasty surgery should not cause problems, especially in a young healthy individual. Knowing that most smokers use tobacco more than they admit , don't have more "slips" which could delay healing after surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.