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Can Smoking Affect Results After Rhinoplasty?

I am 17 days post up after having a crooked nose straightened. Can smoking this soon possibly make my nose crooked or cause movement again somehow by the effects of the smoke?

Doctor Answers (13)

Smoking and nose surgery

+2

Great question!

Cigarettes contain nicotine which is a powerful vasoconstrictor.  This means the chemical chokes all of your blood vessels in your body.

Decreased blood supply means potentially delayed or poor healing and will increase your risk of infection, wound break down and possible need for additional surgery.

Our minimum recommendation for patients who smoke is to stop smoking at least 4 weeks before surgery and resume (hopefully never!) 4 weeks after surgery.

Please note nicotine gum, patch, and second hand smoke are just as bad.


Santa Ana Plastic Surgeon
4.5 out of 5 stars 8 reviews

Smoking and results of rhinoplasty

+2

Smoking itself will probably not directly cause any movement in the structure of your nose, effecting the results of your rhinoplasty. However, smoking always effects the healing process which could indirectly effect your results. For example, it could cause one side to heal with more scar tissue or could effect the soft tissues which could change the results.

If you've gone 17 days without smoking, why not just hold off a little bit longer to avoid the risk of complications.

Best regards,

Dr. Speron

Sam Speron, MD
Chicago Plastic Surgeon

Smoking and cosmetic surgery

+2

Smoking prior to and immediately after cosmetic surgery of any kind is unwise. Cigarette smoke causes blood vessels to constrict, blood to flow more slowly, impairs the body's ability to fight infection and limits oxygen delivery to the healing tissues because of the carbon monoxide in cigarette smoke. This alone should be enough to make you stop smoking for good!

Smoking has obvious cancer causing risks as well as significantly accelerates the skin's aging rate. Remember, you did this to not only look better, but also to be around to enjoy the results. This is a great opportunity to quit, your body will thank you and so will your family!

Best of luck

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 26 reviews

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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 26 reviews

Avoid Smoking in the Pre and PostOp Periods

+1

 

                  We generally recommend that cosmetic surgery patients not smoke in the pre and post-operative periods. Although cigarette smoking won’t cause structural changes, it can adversely impact wound healing.

                  Cigarette smoking can decrease blood supply and oxygen delivery. This can adversely impact wound healing and can increase scarring. Cigarette smoking can also negatively impact pulmonary function. For these reasons, cigarette smoking should be avoided in the pre-operative period. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 74 reviews

Smoking After Rhinoplasty

+1
Any type of smoking has the potential for negative effects and complications for wound healing. It is not good to smoke and especially before or after any type of operative procedure. Smoking is a bad habit.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 15 reviews

Smoking cigarettes after surgery slows healing process

+1

Smoking cigarettes after the rhinoplasty will not make your nose crooked or cause movement due to any affects of smoke on the nasal tissues. It also certainly does not help the healing process and the best idea is to quit smoking.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Smoking and its effect after rhinoplasty

+1

Smoking will not make a straight nose crooked nor will it cause the nose to
move or deviate following surgery. Nevertheless, smoking does alter blood supply and diminish oxygenation to local tissues that may affect surgical healing with any surgical procedure. Smoking is terrible and is a serious health risk. Accordingly, I do not condone smoking in any circumstance.

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

Smoking and cosmetic rhinoplasty surgery

+1

We insist that patients stop smoking before cosmetic surgery because blood suppply is so important for healing! This is especially true with "open rhinoplasty"; however, I doubt that smoking will cause your nose to become "crooked" again after 17 days of healing. The "straightening surgery" depends more on internal structural realignment of nasal cartilages than anything else...not enviornmental factors.

Burr Von Maur, MD
Orange County Plastic Surgeon
4.0 out of 5 stars 7 reviews

Delayed healing in smokers

+1

I agree with the rest of the panel that smoking is detrimental in the immediate post op period, especially in patients who have had an open rhinoplasty. The problem after the fact is it may delay resolution of swelling so I would lay off the cigarettes as long as you can and quit if possible.

Steven Schuster, MD
Boca Raton Plastic Surgeon
4.5 out of 5 stars 3 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.