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If you have previously used Cocaine, then an examination of the inside of your nose is essential before any type of nose surgery. The goal is to make sure that there is no septal damage from the cocaine use. That's all. If there is septal damage, then the surgical plan would need to be modified to account for, or fix, the septal damage. Dr. B
Cocaine causes the blood vessels in the nose to temporarily constrict. Depending on how often and how much a person uses, it can cause part of the septum (cartilage separating the left and right sides of your nose) to die and hence form a perforation. If this is a large perforation, with time it can weaken the nose and lead to collapse of the structure. Most of all my noses I use the septum to create support in the nose during a rhinoplasty. SO it all depends on, if and how much damage the cocaine has caused. Definitely you do not want to be doing cocaine immediately after as it will inhibit the healingGood Luck
nora95,Thanks for the question. Cocaine constricts blood vessels, and its effects on the nose can be traced to this. An area of the septum has terminal branches from multiple blood vessels, making the area susceptible to arterial insufficiency if a potent blood vessel constrictor is applied for prolonged periods of time. If this happens, that part of the septum "dies" and you can get a septal perforation, or hole in the septum. Even in the absence of a hole, you can get thinning of this area with cocaine use, so your doctor should be aware of your past use so they can plan for this. Another effect cocaine can have on your surgery is that your nose gets accustomed to having a blood vessel constrictor applied. This has a decongesting effect on your nose. When you stop using the cocaine, you can get rebound congestion, which is congestion which is worse than you would normally get, because your nose has adjusted to compensate for this decongestant. Surgically, we use topical decongestants (such as cocaine and oxymetazoline) to stop bleeding during a procedure. If your nose has a "tolerance" to one of these substances, your body may not respond appropriately to these medications (that is, your tissues will not stop bleeding when these compounds are applied). Though it may not seem like a big deal, I have seen very large blood losses (and even being forced to stop surgery) during a routine case where a patient was using one of these substances and did not disclose this to their surgeon. The best advice I can give you is to have this discussion with your surgeon and give specific timelines about your use so they can make an informed decision, as I would not want to see anyone harmed from a routine, elective procedure.