Nicotine and Rhinoplasty question. Can this effect the outcome of nasal surgery or increase any risks associated with it?

I've quit smoking because I want a nose job really badly & for my health of course but I quit w/the hell of Nicorette gum, which I am now chewing often. Can this effect the outcome of nasal surgery or increase any risks associated with it?

Doctor Answers 14

Rhinoplasty and Smoking

Thanks for your question! Every physican has their own pre and post-op instructions for rhinoplasty patients. I recommend that my patients discontinue all nicotine products before and after surgery including the gum. This ensures that their nose gets proper blood-flow which largely effects healing and the overall surgical outcome. It's always best to check with your surgeon any time post-op questions come up, since they have the most comprehensive understanding of your history.

Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Avoid Nicotine in All Forms

I would recommend quitting nicotine all-together before undergoing any cosmetic procedure. While it’s true that smoking is worse for your health and more potentially damaging, nicotine in any form (including Nicorette gum) may contribute to issues with constricting blood vessels and adversely affect your body’s ability to naturally heal from your procedure.

David Whiteman, MD
Atlanta Plastic Surgeon
4.4 out of 5 stars 56 reviews

The Effects of Nicotine on Rhinoplasty Results

As a board-certified facial plastic surgeon, I recommend my patients to avoid all nicotine products pre and post surgery. Nicotine consumed in any form constricts the blood vessels, therefore inhibiting rhinoplasty recovery and ultimately increasing swelling and discomfort. Granted, smoking will not alter the results of your rhinoplasty, but it will make your recovery process more difficult than without nicotine. If you find it difficult to cease smoking entirely, a nicotine patch will lessen the risks of recovery issues. The nicotine patch provides a constant low level dose, whereas with nicotine gum, the dose is volatile. I suggest avoiding nicotine for at least a few months into your recovery stage. Your body will thank you!

Sam Rizk, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 74 reviews

Nicotine and Rhinoplasty.

Nicotine use in any form always inhibits healing. For optimal healing it is always recommended to be nicotine free. However, the nose has such a good blood supply that many surgeons, including myself, would still perform the Rhinoplasty if you are using Nicorette gum. If you could switch to a nicotine patch, the risks are most likely lessened. The nicotine patch gives a constant low level dose, whereas with nicotine gum, the dose is variable.

Frederick W. Ehret, MD
Tacoma Plastic Surgeon
4.9 out of 5 stars 46 reviews

What should I do before having rhinoplasty surgery?

is best to stop the use of anything not medically necessary two weeks before your surgery date. Smoking and nicotine can cause constriction of the blood vessels and delay healing.

Jeffrey Weinzweig, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 63 reviews

It is safest to stop all nicotine...

Since nicotine in any form, whether it be cigarettes or gum, can cause constriction of the blood vessels and inhibit proper healing, it is best to stop everything two weeks before surgery if possible. It is not an absolute contraindication, however, as the plane of dissection in rhinoplasty is typically an avascular one, which means that not many blood vessels are divided. Be sure to discuss this with your surgeon so he/she is aware and advises you properly.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 206 reviews

Nicotine and rhinoplasty

Congratulations on stopping smoking.  But, nicorette gum also causes issues with constricting blood vessels and you should probably avoid this as well before surgery.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Smoking and rhinoplasty

Although smoking is not an absolute contraindication to rhinoplasty, it adversely affects healing process by decreasing tissue blood supply and creating a direct irritation and swelling  of intranasal mucosa. So it is great that you quit smoking way in advance of having the surgery. Chewing the Nicorette gum should not affect your postoperative results. 

Alexander Ovchinsky, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

Rhinoplasty and smoking

This is a terrible combination for surgical outcomes. I would seriously avoid smoking and rhinoplasty. The risk for skin loss is significant. Unfortunately nicotine gum causes many of the same physiologic changes as the cigarettes.

Avron Lipschitz, MD
Stuart Plastic Surgeon
5.0 out of 5 stars 65 reviews

Nicotine and rhinoplasty

Nicotine with decrease the blood flow to the skin's small blood vessels. When doing a rhinoplasty the skin is separated from the underlying skeletal structures, further decreasing blood flow, especially to the tip area. Then the necessary use of epinephrine, again decreases blood flow for a few hours during surgery. Also retracting on tissues during surgery further decreases blood flow.
So what you have is a set up for trouble if you use nicotine.
On top of all this, if you smoked a long time, you have already decreased blood to your tissues due to small vessel disease.
If tip grafts are needed, this will further decrease tip blood supply.
I would not operate on someone who is currently on nicotine.

Dennis Barek, MD
Great Neck Plastic Surgeon
4.4 out of 5 stars 8 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.