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 19

Smoking and nose surgery

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
4.5 out of 5 stars 13 reviews

Effect of Smoking on Rhinoplasty

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.

Smoking and results of rhinoplasty

Smoking itself will probably not directly cause any movement in the structure of your nose, effecting the results of your rhinoplasty. However, smoking always effects the healing process which could indirectly effect your results. For example, it could cause one side to heal with more scar tissue or could effect the soft tissues which could change the results.

If you've gone 17 days without smoking, why not just hold off a little bit longer to avoid the risk of complications.

Best regards,

Dr. Speron

Sam Speron, MD
Chicago Plastic Surgeon

Delayed healing in smokers

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 and cosmetic surgery

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 38 reviews

Smoking after a Rhinoplasty

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 78 reviews

Smoking after Rhinoplasty

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
5.0 out of 5 stars 9 reviews

Smoking after rhinoplasty

Smoking is never a good idea and has innumerable detrimental effects to your health including cardiac, pulmonary, neoplastic, etc.  It also impairs wound healing and may increase risk of infection in the post-operative period.  Having said that, it will not change the shape of your nose after rhinoplasty.  In some instances, it can lead to skin necrosis if there is an area that is poorly vascularized.  This is usually not a concern for primary rhinoplasty, but could be if someone has had several revisions.

Sirius K. Yoo, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews


It's extremely important that patients avoid the use of tobacco before and after surgery since this substance inhibits the recovery process. You should not smoke in the three weeks leading up to the nose job operation and for another three weeks afterward. This is primarily due to inhibiting blood circulation and making it more difficult to fight infection. 

Smoking after rhinoplasty

Healing wounds after surgery are negativly affected by smoking because the nicotine cuts off the blood supply to the wound. Therfore bad scarring and potential infections can result. Don't smoke after surgery.


Thomas Romo, III, MD, FACS
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 40 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.