ByDr. Scott J Turner, Specialist Plastic Surgeon
Last Updated May 2025
Achieving the best possible results from rhinoplasty surgery requires more than just selecting a skilled surgeon—it demands thorough preparation on your part. As a patient considering rhinoplasty surgery, understanding what to avoid before your operation is just as important as knowing what to expect afterwards. While Dr. Turner’s expertise as a Specialist Plastic Surgeon guides the surgical process, your preparation in the weeks leading up to surgery significantly influences healing, recovery time, and ultimately, your final aesthetic result.
This comprehensive guide outlines critical pre-surgical avoidances to help you prepare optimally for your rhinoplasty procedure at our Manly and Double Bay clinics. Whether you’re having standard rhinoplasty, functional rhinoplasty to improve breathing, or revision rhinoplasty, proper preparation is essential.
Table of Contents
Medications to Avoid Before Rhinoplasty
One of the most critical aspects of preoperative preparation is discontinuing certain medications that can increase bleeding risk. Unless otherwise instructed by your surgeon or primary care physician, it’s recommended to stop these medications 14 days before surgery:
NSAIDs and Antiplatelet Agents
- Aspirin (irreversible COX-1 inhibition persists 7-10 days)
- Ibuprofen (Advil, Motrin, Nurofen)
- Naproxen (Aleve, Naprosyn)
- Other common products containing aspirin or NSAIDs (Alka-Seltzer, Anacin, Bayer products, Bufferin, Excedrin, some cold/sinus medications)
These medications can increase intraoperative blood loss, potentially obscuring surgical landmarks and distorting cartilage shaping during your procedure.
Blood Thinners (Anticoagulants)
If you’re on prescribed blood thinners such as warfarin or clopidogrel, a specific management plan will need to be discussed with both your surgeon and prescribing doctor.
Acceptable Pain Relief Alternatives
Paracetamol (Panadol) is generally permitted for pain relief before surgery, but always confirm with your surgical team.
Important Note: Never discontinue any prescribed medication without explicit advice and approval from your regular physician or the original prescribing specialist. Abruptly stopping medications for chronic conditions can have serious health consequences.
Supplements to Avoid Before Rhinoplasty
Many herbal supplements and vitamins can affect blood clotting or interact with anesthesia. These should be discontinued at least 21 days before surgery:
High-Risk Supplements
- Vitamin E: Impairs platelet aggregation and can increase bleeding risk by up to 30%
- Omega-3 Fatty Acids (Fish Oils): Reduce thromboxane synthesis and can complicate hemostasis
- Garlic Supplements: Allicin metabolites inhibit platelet activation, prolonging bleeding time
- Ginkgo Biloba: Inhibits platelet-activating factor receptors, increasing hematoma risk
- Ginseng: Prolongs prothrombin time through factor VII modulation
Other Supplements to Discontinue
- St. John’s Wort: Can reduce anesthetic efficacy via CYP3A4 induction and has MAOI/SSRI-like effects
- Echinacea: May increase postoperative edema
- Valerian Root: Potentiates the effects of anesthesia
- Green Tea Extract: Has mild antiplatelet effects
- Turmeric/Curcumin: In concentrated supplement form
- Multivitamins: Often contain vitamin E and minerals that may affect platelet function
- Other herbal supplements: Including alfalfa, chamomile, dong quai, feverfew, licorice, melatonin
Vitamin C Considerations
Vitamin C supplementation is controversial before rhinoplasty. While some surgeons prohibit it over theoretical collagen dysregulation risks, others support its continuation for wound healing benefits. Discuss this specifically with Dr. Turner during your consultation.
Lifestyle Factors to Avoid
Nicotine Cessation
Complete nicotine avoidance is required for 8 weeks preoperatively and 4 weeks postoperatively. Smoking significantly impairs healing by:
- Reducing nasal tip blood flow by 40-60%
- Increasing skin necrosis risk by 2.7 times
- Raising revision surgery rates to 31% (compared to 9% in non-smokers)
This includes all forms of nicotine—cigarettes, e-cigarettes, vaping devices, nicotine patches, and gum. Some surgeons may postpone surgery if a patient is found to be using nicotine at the time of surgery, potentially through pre-operative testing.
Alcohol Consumption
Complete abstinence for 7 days pre-op prevents:
- Coagulation issues from alcohol-induced thrombocytopathy
- Anesthetic complications
- Increased postoperative nausea
- Impaired immune function that can hinder healing
Chronic alcohol users (>14 units/week) may require liver function tests to assess metabolic capacity for anesthetic agents.
Recreational Drugs
The use of recreational drugs presents significant and unpredictable risks with surgery and anesthesia. Patients should avoid all recreational drugs for at least two weeks prior to surgery.
Specific substances of concern include:
- Cocaine: Particularly dangerous for rhinoplasty due to vasoconstriction, can lead to tissue necrosis and septal perforation
- Cannabis: Should be discontinued at least one week before surgery as it can affect anesthesia requirements
- Stimulants: Can cause cardiovascular instability and interact with anesthetic medications
Dietary Considerations
Fasting Guidelines
You will receive specific instructions about when to stop eating and drinking before your surgery, typically nothing by mouth (NPO) after midnight the night before or at least 8 hours prior to the procedure. This is crucial for anesthesia safety to prevent pulmonary aspiration. Failure to comply with this instruction may lead to the cancellation of your surgery.
Note: The only exception is for specific essential medications that your surgical team has explicitly instructed you to take on the morning of surgery, which may be consumed with a small sip of water only.
Foods to Avoid 48 Hours Pre-Op
- Garlic and onions (in large amounts): These have natural blood-thinning properties
- Highly processed and salty foods: Reducing salt intake can help minimize swelling
- Grapefruit: Contains bergamottin which can interfere with anesthesia medication metabolism
- High-fiber meals: Should be avoided 24 hours before surgery to ensure gastrointestinal tract clearance
Recommended Dietary Focus
- Hydration: Aim for adequate water intake (3-4 liters daily) in the weeks before surgery
- Balanced nutrition: Maintain a diet rich in essential nutrients, particularly protein for tissue repair
- Vitamin-rich foods: Include plenty of fruits and vegetables to support healing
Day-of-Surgery Preparations
Skin, Hair, and Cosmetics
- Shower with anti-bacterial, fragrance-free soap the day before and morning of surgery
- Arrive with a clean face, free of any makeup, lotions, or creams
- No hair sprays or gels
- No acrylic nails or nail polish (including gel/powder)
- No eyelash extensions or mascara
Attire and Personal Belongings
- Wear loose-fitting clothes that button or zip up the front (avoid clothing pulled over the head)
- Slip-on shoes are practical
- Remove all jewelry, including rings, necklaces, earrings, and body piercings
- Do not wear contact lenses; eyeglasses are permissible
- Leave valuables at home
Essential Health Information for Your Surgical Team
Full Disclosure Requirements
- Complete medication list: Provide your surgeon with a comprehensive list of ALL medications (prescription, over-the-counter), supplements, and herbal remedies
- Pre-existing medical conditions: Disclose all conditions such as diabetes, hypertension, bleeding disorders, heart or lung disease
- Allergies: Report all known allergies to medications, anesthetic agents, tape, latex, or other materials
- Non-pregnancy confirmation: Female patients must inform their surgeon if there is any possibility of pregnancy, as surgery will need to be rescheduled in this case
Last-Minute Health Changes
Inform your surgeon’s office immediately if you develop:
- Cold, flu, fever, or sore throat
- Active acne breakout near the nasal area
- Any significant change in your health status
Understanding the Risks of Non-Compliance
Adherence to pre-operative instructions is not merely a suggestion but a critical component of patient safety and achieving successful outcomes. Failure to comply can lead to:
Medical Risks
- Increased bleeding and hematoma formation: Can cause pain, delay healing, and compromise results
- Impaired wound healing and infection: May lead to prolonged recovery and unfavorable scarring
- Anesthesia complications: Undisclosed medications or supplements can cause dangerous interactions
- Compromised surgical results: May necessitate revision surgery
Practical Consequences
- Surgery postponement or cancellation: Non-compliance with critical safety guidelines (such as fasting rules or nicotine use) often leads to rescheduling
- Extended recovery time: Complications from non-adherence typically prolong the healing process
Conclusion
Following these preoperative guidelines is essential for a successful rhinoplasty outcome. By avoiding the substances and activities outlined above, you’ll reduce risks and support optimal healing.
Dr. Scott J Turner and our team provide support throughout your surgical journey to help you achieve the best possible results from your rhinoplasty, functional rhinoplasty, or revision rhinoplasty procedure.
If you have any questions about preparing for your rhinoplasty or would like to schedule a consultation, please contact our team at our Manly or Double Bay clinics.
Remember that Dr. Turner will provide personalized preoperative instructions based on your unique health profile. Always follow these specific instructions for the best outcome.
Disclaimer: This guide is for informational purposes only and should not replace the specific instructions provided by your surgeon and medical team.
