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Cocaine use greatly increases the risk of septal perforation after septorhinoplasty because it compromises the blood supply to the septum. With chronic use it's not uncommon to develop septal perforation even without surgery. In addition to being cardiotoxic (damaging to your heart), cocaine use can increase the risk of anesthesia complications.
Do not proceed with your surgery as you are at marked increased risks of complications from both recent use of cocaine and ongoing nicotine use. You need to have medical clearance at a minimum from the anesthesiologist who needs to know of this history, and need to be off both cocaine and nicotine for months prior to elective surgery. I also strongly recommend that you are candid with your surgeon and never hold back medical details that could affect your health. There is a sacred patient physician relationship restricting him from sharing any of your medical information
Even recreational cocaine use may put you at risk for rhinoplasty related complications like septal perforation, and poor cosmetic outcome. Cocaine use post-operatively may also lead to poor healing, and functional collapse of your nose. Hope this is helpful. Dr. Joseph
Cocaine use can have a tremendous impact on plastic surgery, none of which is favorable.There is its cardiovascular effects on general anesthesia as well as its specific deleterious effects on the nasal lining should you be considering rhinoplasty. This does not mean you can not have plastic surgery but this information should not be withheld from your surgeon in your presurgical assessment.
Cocaine use will compromise nasal circulation and increase the risk of rhinoplasty surgery. Be sure to share your history of drug abuse with your surgeon to minimize the potential complications if you have surgery.