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Cocaine Use and Its Effects on Rhinoplasty

woman with bandage on nose
By Robert Kotler, MD, FACSJanuary 05, 2010
From the WebMD Archives

Sadly, people still abuse cocaine. What happens to the body after is never good. The worst effect is what happens to the heart and blood vessels – high blood pressure that can possibly lead to a stroke or even death.

How does this relate to nose surgery? Surgical problems are always an issue for patients abusing cocaine. Two problems come to mind. The inside of the nose is irritated and inflamed, which makes it impossible to safely do nasal surgery. Secondly, cocaine abusers can have a hole within the internal partition of the nose. We call this a nasal septal perforation. The size of the hole can range from a pen tip to the size of a nickel.

Crusting, whistling and bleeding can result from septal perforations. It creates many challenges. The greatest one being the difficulty for the surgeon to surgically close that hole. It is possible to insert some appliances that can act as a “stopper,” but a long-time cocaine abuser will most likely have problems.

It is also important for me to mention that a patient should NEVER have cocaine in their system during surgery. The mixture of cocaine, anesthetic drugs and the local anesthetic could be catastrophic!

It is better to be honest with your doctor, rather than feel embarrassed. Your doctor will not judge you. In fact, whatever is told to the doctor is completely confidential and can never be revealed without the permission of the patient. Being honest with your doctor will result in a safer and more positive surgical experience.

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