I Keep Smoking Till 8 Hours Before my Surgery How I Can Know Now That my Nose Skin Now Dies or Any Damage Caused?

I had rhinoplasty last Thursday which took 3 hours and tho my surgeon knows that I'm smoker he didn't tell me anything about stopping smoking because healing process ... And I didn't know as well ... Just afraid surgery I start reading articles and now I'm worry and don't know what do to ... And actually 18 month ago I had another surgery for fixing broken bones (26)in nose and also breathing problem and it took 4 and half hours and that time i wasn't smoker , I started smoking last year

Doctor Answers (6)

If you have skin necrosis you will have to consider the smoking as part of the problem

+2

Hello,

Thank you for the question.  Smoking impacts healing in several ways and perhaps most importantly at the micro-circulation level (in the skin).  If your skin does not have enough blood supply it will die which is called necrosis.  This will be evident near your incision at the columella.  Do not smoke during your recovery.  That is the most important thing that you can do at this time.

All the best,

Dr. Remus Repta


Scottsdale Plastic Surgeon
5.0 out of 5 stars 98 reviews

Smoking and rhinoplasty surgery

+2

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. It would be a good idea to follow up with your surgeon to ensure you are recovering properly. I hope this helps, and I wish you the best of luck with the remainder of your recovery.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Smoking and surgery

+2

Smoking and surgery do not mix.  Smoking increases wound healing problems significantly. I usually tell patients to at least stop 4 weeks prior and continue 4 weeks after.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 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

Smoking and rhinoplasty

+1

 It his best to stop smoking approximately 2 weeks before and 2 weeks after a rhinoplasty for optimal healing.  tobacco smoke will return to internal healing process of the nose.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Smoking before and after Rhinoplasty

+1

   If the skin has not died after a few days, most of the time the risk of flap death is small.  You may end up with healing problems, and you really should inform your plastic surgeon and stop smoking immediately.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 230 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.