Is vaporizing marijuana safe after septo/rhinoplasty?

Question

I just had a septoplasty with minor rhinoplasty adjustments two weeks ago, so far the healing is going well, still a bit swollen as normal for now. I have been avoiding smoking since I know it can interfere with the healing, but I was wondering if it would be ok to vaporize the marijuana instead? All in accordance with prop 215 and I am a legal medical marijuana patient. I appreciate any help on this.

Michael A. Persky, MD · Answer

Hi Surfride,We know of no studies on the safety of  marijuana vapors two weeks after nasal surgery.  You should ask your surgeon.  If it is okay with your surgeon, proceed but be careful around Oreos, M&Ms, and fudge brownies (and enjoy the attached Cheech and Chong "Up in Smoke" video clip.)  Good luck and be well.Dr. P

Michael M. Omidi, MD, FACS · Answer

Thank you for your question. You should absolutely consult with your physician about your smoking habits in order to obtain the most reliable and individualized medical advice. It's best to avoid smoking for at least two weeks prior to rhinoplasty. This applies not only to conventional cigarettes, but also to marijuana. Also make sure to avoid using marijuana 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.  I'd recommend to consult with your plastic surgeon as he or she may have different guidelines for smoking. 
An in-person exam with a board certified plastic surgeon is always the best way to fully assess your needs and address your concerns. Best of luck!

Pablo Prichard, MD · Answer

Here are the major points of smoking Tobacco or Marijuana before or after surgery:1. There is nicotine in tobacco, but not in marijuana. However, most joints are rolled with marijuana and tobacco combination. Nicotine is a vasoconstrictor that decreases blood flow to the tissues. This is the major problems that can cause a very bad outcome in some surgeries. In a breast augmentation, there is not a lot of risk as there are not a lot of incisions which decrease blood flow to the tissues. In a breast lift or tummy tuck, on the other hand, there is much longer and more involved incisions. The decrease in blood flow to the tissues in combination with the decrease in blood flow from the nicotine can cause tissue to die. This can cause part of the breast or nipple, or in the case of a tummy tuck, part of the belly tissue to die, resulting in a very bad outcome. This is especially bad in breast reductions or face lifts. In a rhinoplasty the tip of the nose and the columella, the area between the tip and the lip, is at risk. Your skin and tissue can turn black and fall off if this happens. In fat transfer, the constricted blood flow can cause the fat to not get a blood supply and die.  Marijuana without tobacco does not cause this problem, or marijuana in an edible fashion. Vaporizers do not decrease the amount of nicotine in tobacco, only decrease the smoke. Hookah also does not decrease nicotine.2. There is carbon monoxide in both tobacco smoke and marijuana smoke. Carbon monoxide decreases the oxygen carrying capacity of hemoglobin in the blood. This is different from the vasoconstrictor effect, but has the same result of having the risk of tissue death in conjunction with surgeries that decrease the blood flow to tissues such as breast lifts and tummy tucks, as opposed to an augmentation alone that does not decrease blood flow to as great of an extent. Again, edible forms of marijuana do not have smoke, and thus carbon monoxide poisoning.3. Coughing. Both tobacco and marijuana smoke disrupt the lining of the lungs and bronchi and can lead to coughing episodes. Coughing episodes can lead to internal bleeding after surgery that can lead to hematomas and complications, and again a bad outcome. Again, edible forms of marijuana does not have this effect.4. Anesthesia effects. Marijuana can have drug interactions with certain anesthetic drugs. Thus it is important to tell your anesthesiologist about your marijuana use.In conclusion, Smoking, whether it be tobacco or marijuana, is detrimental to your surgery outcome. Edible marijuana is much less so, but be honest about your use with your surgeon and anesthesiologist so that you can have the best outcome. In general, you should quite smoking many weeks, ideally 6 weeks before surgery, and not smoke for at least 2 weeks after surgery.Best wishes,Pablo Prichard, MD

Is vaporizing marijuana safe after septo/rhinoplasty?

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Is vaporizing marijuana safe after septo/rhinoplasty?

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Everything you need to know about Rhinoplasty

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