Unfortunately, cocaine use is still with us.  There are significant consequences to cocaine abuse.  The worst complication is its effect on the heart and blood vessels which causes high blood pressure that can possibly lead to a stroke – or even death.

With respect to nose surgery, patients who have been abusing cocaine present significant surgical problems.  First, the lining of the nose is terribly inflamed and irritated and it is impossible to conduct a proper operation under those circumstances.  Secondly, the abuse of cocaine can lead to creation of a hole within the internal partition of the nose. This is known as a nasal septal perforation.  The hole can be anywhere from the size of the tip of a fountain pen to the size of a nickel.  

There are problems that come with septal perforations:  crusting, whistling and bleeding. It is a real hassle. And once that hole is created, it is very difficult to surgically close it.  While there are some appliances that can be inserted to act as a “stopper,” just be aware that one is asking for considerable problems with long-term cocaine abuse.

The other issue is that one should never consider having any cocaine in their body at the time of surgery.  This sets the stage for a possible anesthetic catastrophe! There can be an unfavorable interaction with the anesthetic drugs as well as the local anesthetics that must be injected.  

Remember, doctors are not judges. We are not an arm of the legal system. Our conversations and records are private and cannot be shared with anyone without your permission.  We don’t have an editorial position on personal choice issues. Our only job is to serve you. However, you need to be frank and honest with your doctor whose only aim is to have a safe surgery and a satisfactory outcome for his patient.