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

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.

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.

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.

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!

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.

Hi and thanks for your question.  Yes, nicotine in any form is very bad for healing.  Nicotine makes your blood vessels constrict which hurts the noses ability to heal.  We need for your blood vessels to be open for optimal healing.  I tell patients to stop smoking forever because it is very bad for many reasons, but at the very least, I need for patients to stop nicotine for 1 month before and 1 month after surgery.  

Thank you for your question.  Smoking cigarettes and/or the use of nicotine products does increase all the risks associated with surgery to include but not be limited to, increased risk of bleeding, swelling, bruising, infection, delayed wound healing or the potential need for additional surgery.  The best advice is to try to stop use of all nicotine products at least two weeks prior to surgery and not resume use of these products for a minimum of 4 weeks after surgery.Best regards,Dr. Lane F. Smith, MDPlastic SurgeonLas Vegas, NV

Thanks for sharing your concerns with us. In my practice I recommend to stop smoking at least 1 month before the surgery and two months after it to avoid unnecessary risks. Respectfully, Dr. Emmanuel Mallol Cotes.- 

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.

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.