I did cocaine 12 days before rhinoplasty, is that okay?

Question

I did cocaine on Tuesday September 12,2017 til morning here and there. It was a little bump each time. I have a rhinoplasty on the 25th... will i be ok for surgery? Will the nose be ok as long as I don't do cocaine anymore after the surgery? I really want to do my surgery. I will be 12 days sober.

Manish H. Shah, MD, FACS · Answer

Hello,Thanks for your question. Unfortunately, it would be wise to postpone your surgery until your nose can heal from the cocaine exposure. Cocaine is an extremely strong vasoconstrictor. This means it cuts the blood supply off inside your nasal tissues. An extreme problem with nasal cocaine users is septal perforation leading to a collapsed saddle nose deformity. That's simply not a risk you want to take. Let your surgeon know whats happened and reschedule when it safe to proceed with surgery.Good luck,Dr. Shah

Daniel B. Kim, MD · Answer

Thank you for reaching out. Just be sure to share all info and be fully honest with your doctor and anesthesiologist, they will be the ones to determine if it is ok to proceed. Best of luck. Dr. Kim

Usha Rajagopal, MD · Answer

It is important to let the surgeon and anesthesiologist know because anesthesia medication would need to be adjusted or modified. Secondly, with the rhinoplasty, cocaine can affect the septum that is the cartilage that separates the nostrils. It can also sometimes result in death of parts of the septum creating a hole in the septum so it is important to discuss that with your rhinoplasty surgeon.

Tim Sayed, MD, MBA, FACS · Answer

Cocaine use is associated with injury to the lining of the nose. While we often use medicinal dilute cocaine (4%) for shrinking the lining during surgery (in order to minimize bleeding and swelling), recreational use can cause temporary and permanent damage and cause unplanned issues with the rhinoplasty. Furthermore, obviously cocaine use does not have medicinal benefit when used recreationally and can't be sanctioned as "ok" for surgery in good conscience. Probably a good idea to discuss with your surgeon and consider a temporary delay in surgery.

Ziyad Hammoudeh, MD · Answer

Cocaine causes constriction of blood vessels and thus compromises blood supply.  Repeated use can lead to septal perforation and collapse of the nose.  The safest thing to do at this point would be to hold off on nasal surgery to allow your nose to recover.  Be honest with your surgeon, so he/she is aware of the issue and can help make the safest plan going forward.
Ziyad Hammoudeh, MD

I did cocaine 12 days before rhinoplasty, is that okay?

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