Can Smoking Affect Results After Rhinoplasty?

I am 17 days post up after having a crooked nose straightened. Can smoking this soon possibly make my nose crooked or cause movement again somehow by the effects of the smoke?

Doctor Answers 23

Smoking and nose surgery

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Great question!

Cigarettes contain nicotine which is a powerful vasoconstrictor.  This means the chemical chokes all of your blood vessels in your body.

Decreased blood supply means potentially delayed or poor healing and will increase your risk of infection, wound break down and possible need for additional surgery.

Our minimum recommendation for patients who smoke is to stop smoking at least 4 weeks before surgery and resume (hopefully never!) 4 weeks after surgery.

Please note nicotine gum, patch, and second hand smoke are just as bad.

Santa Ana Plastic Surgeon

Smoking and cosmetic surgery

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Smoking prior to and immediately after cosmetic surgery of any kind is unwise. Cigarette smoke causes blood vessels to constrict, blood to flow more slowly, impairs the body's ability to fight infection and limits oxygen delivery to the healing tissues because of the carbon monoxide in cigarette smoke. This alone should be enough to make you stop smoking for good!

Smoking has obvious cancer causing risks as well as significantly accelerates the skin's aging rate. Remember, you did this to not only look better, but also to be around to enjoy the results. This is a great opportunity to quit, your body will thank you and so will your family!

Best of luck

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Effect of Smoking on Rhinoplasty

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Thank you for your question.

The effects of smoking on nasal surgery (or any other surgery, for that matter) are multi-factorial, and play into the common recommendations regarding tobacco use before and after surgery.

Tobacco use is a bad idea in surgical patients because it contains nicotine, which is a powerful vasoconstrictor, cutting off blood to the tissues which are traumatized during surgery and often having a horrible detrimental effect on healing and scarring and possible infection.  This is true of cigarettes, cigars, chewing tobacco, nicotine gum, or electronic cigarettes that contain nicotine.  

In the case of cigarettes or cigars in particular, this negative impact on healing is compounded by the increased exposure to carbon monoxide which results from the actual combustion of the tobacco.  While the nicotine affects blood flow, carbon monoxide affects the blood's ability to carry oxygen, thereby decreasing oxygen delivery to the healing tissue that needs it so much.

Specifically regarding your concerns regarding making your nose crooked again or causing movement, it's possible that the delay in healing that occurs as a result of smoking can decrease the stability and strength of your nose at this stage - typically by 17 days, the bones are "stuck" in place, but in a smoker, the delay at this time can leave you more vulnerable to trauma and resulting unintentional repositioning of the bones.

Bottom line - anything that affects healing or the risk of infection will increase the risk that you'll get unwanted results and increase the likelihood that you'll need more surgery down the road - a prospect which is neither pleasant nor easy.

Delayed healing in smokers

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I agree with the rest of the panel that smoking is detrimental in the immediate post op period, especially in patients who have had an open rhinoplasty. The problem after the fact is it may delay resolution of swelling so I would lay off the cigarettes as long as you can and quit if possible.

Smoking after rhinoplasty

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Thank you for the question. You should absolutely consult with your physician about your smoking habits in order to obtain the most reliable and individualized medical advice. Most specialists recommend abstaining from smoking for 2-3 weeks before a rhinoplasty, while others may insist on a full month or two. Smoking will cause irritation and restrict the blood flow to your healing areas, possibly causing complications during the recovery period.   

In addition, you should also make sure to avoid smoking for at least two weeks after surgery as it may interfere with your healing process. Smoking after surgery may restrict the flow of blood to the healing areas, exacerbate swelling, and prolong recovery. Of course, as a physician, I would advise you to quit smoking altogether due to a variety of health risks associated with it. 

 An in-person exam with a board-certified plastic surgeon would be the best way to assess your needs and obtain expert medical advice. Best of luck!

Michael M. Omidi, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 120 reviews

General Rhinoplasty Instructions

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Thank you for your question. Most doctors advice no smoking at all for four weeks before and after surgery. Smoking delays and interferes with healing. It does not make your nose crooked, but it can delay and interfere how it looks when it heals. 

All the best, 

Deepak Dugar, MD
Scarless Rhinoplasty Expert
Beverly Hills, CA 90210

Deepak Raj Dugar, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 20 reviews

If you haven't smoked for 17 days after your rhinoplasty, consider quitting.

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Cigarette smoking is an unhealthy and addictive habit that should be avoided. Using tobacco, however, should not interfere with your nasal healing since your nose has a rich blood supply and should not be significantly affected by the vasoconstrictive properties of nicotine.Wishing you well. Dr Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Smoking after a Rhinoplasty

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Thank you for your question. It is really never a good idea to smoke while you are recovering after surgery. Nicotine causes the blood vessels to constrict which means they decrease in their size and blood flow thorough them drops off.  Nicotine can also make the blood clot more easily which can further clog small blood vessels and capillaries. These effects are extremely serious because they decrease the blood supply to the tissues, can result in wounds not healing, and can result in some devastating complications. It is best to not smoke at all while you are recovering. Best of luck!Dhaval M. Patel Double board certified Plastic surgeon Hoffman Estates Barrington Oakbrook Chicago

Dhaval M. Patel, MD
Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 100 reviews

Smoking after a Rhinoplasty

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So as we all know smoking is bad for you and that is no secret.  It is very bad for you when you have surgery because it inhibits wound healing.  This means the incisions may not heal as well or other tissue related problems like infections. Therefore the longer you can hold off from smoking after your surgery the better.  There is no rule but at the minimum you want to wait 1-2wks.  I have had many patients take this opportunity to quit and have been successful. 

Rady Rahban, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 141 reviews

Smoking after Rhinoplasty

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Smoking can definitely affect the healing process. Cigarette smoke causes blood vessels to constrict, blood to flow more slowly, impairs the body's ability to fight infection and limits oxygen delivery to the healing tissues because of the carbon monoxide in cigarette smoke. I would not recommend smoking after Rhinoplasty.

Karl Schwarz, MD
Montreal Plastic Surgeon

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.