Cocaine use after rhinoplasty and revision rhinoplasty

Cocaine causes damage by shrinking up the blood vessels. Without blood, the cartilage and tissue in your nose dies. This may lead to a hole in your septum and potentially a total collapse of your nose. The first thing to do is to stop using cocaine along with any decongestant sprays. 1 year free of drugs is a necessity. This gives the tissue in your nose a chance to recover its healing blood supply.Next, you need to see someone trained in revision rhinoplasty to evaluate your nose. They can examine your nose and pass a short camera into your nose to see the extend of the damage. Is it just thin or is there a hole (perforation)? Is the nose holding its shape or is there signs of collapse (saddling)? Photographs will help analyze your nose.With that information, they can formulate a treatment plan and answer any questions. 

Revision rhinoplasty after years of cocaine abuse can be performed, but must be approached with extreme caution. The risk of a complication, like a septal perforation, poor graft healing, infection and scarring is increased dramatically. Even after stopping cocaine use for one year (the minimum recommended time), your risk is higher than someone who has never used cocaine.Cartilage grafting, if needed, will likely not come from your septum, since this cartilage has been traumatized during your years of abuse. Ear or rib cartilage will be the best bets.Start by having an examination by a surgeon who can assess your airway and the strength of your cartilages. After that he can help you plan your surgery for a time when you are drug free and ready.Congratulations on stopping your abuse. Take the next step to improve your life when you're clean for one year, and are ready for the challenges of revision rhinoplasty.

   Cocaine abuse can destroy the cartilage on the inside of the nose creating a septal perforation and collapse. It's important to have a thorough internal examination of the nose to determine if there is enough cartilage for potential grafting purposes with a revision rhinoplasty. If there is collapse of the septum/ septal perforation, then ear cartilages the next best source. It is also best to wait at least one year after any cocaine abuse before electing to undergo a difficult revision rhinoplasty procedure.

You are not a candidate for elective rhinoplasty.You need to be free of use of any illicit drugs for at least 5 years, regardless of the amount and frequency of use,  before considering elective surgery.