What to Avoid Before Rhinoplasty Surgery

Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) | Sydney

Rhinoplasty outcomes are shaped by more than what happens in the operating theatre. What you do in the weeks beforehand matters too. Certain medications, supplements and habits can increase bleeding risk, slow healing, or interact with anaesthesia in ways that affect both safety and recovery. Knowing what to pause, and when, is a real part of preparing well. If you are still researching the operation itself, the rhinoplasty Sydney page covers the procedure, suitability, risks and recovery.

This guide covers the main things to stop or avoid before rhinoplasty, and why each one matters. My team provides specific pre-operative instructions tailored to your procedure and health history at your pre-surgery appointment. Always follow those instructions directly. This guide is a general reference, not a substitute for personalised surgical advice.

I am Dr Scott J Turner, a Specialist Plastic Surgeon (FRACS), and I consult for rhinoplasty at my Sydney clinics in Bondi Junction and Manly.

Medications to stop before rhinoplasty

Anti-inflammatories and blood thinners

This is the most important category. Aspirin, ibuprofen (Nurofen, Advil), naproxen (Naprogesic) and other non-steroidal anti-inflammatory drugs (NSAIDs) reduce the blood’s ability to clot. Taking them before surgery increases the risk of bleeding during the operation and in the early recovery period. Stop all NSAIDs at least two weeks before surgery.

Paracetamol (Panadol) is safe for pain relief in the lead-up to surgery and is the recommended alternative.

Prescription blood thinners such as warfarin, rivaroxaban, apixaban, clopidogrel, and aspirin prescribed for cardiovascular reasons need careful management. Do not stop these on your own. Discuss the timing with both my team and the prescribing doctor well in advance of your surgery date.

Hormone-based medications

The oral contraceptive pill and hormone replacement therapy (HRT) increase the risk of blood clots, including deep vein thrombosis and pulmonary embolism, around the time of surgery. I will advise on whether to pause these before rhinoplasty, and if so for how long. That conversation needs to happen at consultation, not the week before surgery.

Antidepressants and other prescription medications

Some antidepressants, particularly MAOIs and SSRIs, can interact with anaesthetic agents or affect bleeding. Do not stop any prescribed psychiatric medication without discussing it with your prescribing doctor first. The anaesthetist will review your complete medication list before surgery and advise on any adjustments.

Supplements to stop before rhinoplasty

Many common supplements affect blood clotting and should be stopped at least three weeks before surgery. The ones to be most aware of:

• Vitamin E: one of the more significant supplement-related bleeding risks. Stop at least three weeks before surgery.
• Fish oil and omega-3 supplements: reduce clotting. Stop three weeks before surgery.
• Garlic supplements: affect platelet function. Stop three weeks before surgery. Garlic as a cooking ingredient is fine.
• Ginkgo biloba: affects clotting. Stop three weeks before surgery.
• Ginseng and St John’s Wort: both interact with anaesthesia and affect bleeding. Stop three weeks before surgery.
• Vitamin C and multivitamins: discuss with my team. Standard multivitamin doses are generally lower risk, but high-dose supplementation should be flagged.

When in doubt, stop it. If you are unsure whether a supplement you take is relevant, bring a complete list to your pre-operative appointment.

Nicotine

Stopping nicotine well before rhinoplasty is one of the most clinically significant things you can do to support your healing and lower your risk. Nicotine constricts blood vessels, reduces oxygen delivery to healing tissue, and significantly increases the risk of complications including poor wound healing, prolonged swelling, infection, and skin necrosis in severe cases.

This applies to all forms of nicotine: cigarettes, vaping, patches, gum, and lozenges.

Stop at least eight weeks before surgery. This is not a preference, it is a clinical requirement. I may postpone surgery if nicotine use is identified at or before the operation, and nicotine testing may be performed pre-operatively.

Alcohol

Alcohol affects clotting, interacts with anaesthesia and pain medication, and impairs immune function during the healing period.

Stop alcohol at least two weeks before surgery. Some patients find it easier to stop completely from the point of booking through to surgery, which is encouraged.

Herbal teas and natural remedies

Several herbal teas and natural remedies have blood-thinning or drug-interaction properties that are not widely known. Chamomile, ginger, green tea in large quantities, and various Chinese herbal medicines can all affect bleeding or anaesthesia. Disclose anything you take regularly at your pre-operative appointment, including things that seem harmless. If you are partway through a herbal program of any kind, mention it rather than assuming it is too minor to matter.

Tell your surgeon everything

The most useful thing you can do before surgery is give a complete picture of your health. That means every medication and supplement, not just the ones you think are relevant, along with any bleeding tendencies, previous reactions to anaesthesia, snoring or sleep apnoea, and any medical condition you are being treated for. Things that feel minor to you can change how surgery and anaesthesia are planned. Recreational drug use matters too, and it is treated confidentially. The more your surgical and anaesthetic team know in advance, the fewer surprises on the day, and the safer the whole process is. If you want a sense of the errors that set recovery back afterwards, the post-rhinoplasty recovery mistakes guide is a useful companion to this one.

Fasting instructions

You will receive specific fasting instructions from my team and the hospital before surgery. These must be followed exactly.

As a general guide, rhinoplasty requires:

• No food from midnight the night before surgery, or for at least six to eight hours
• No water or clear fluids from two hours before surgery
• Essential medications may be taken with a small sip of water only, as specifically directed by the anaesthetist

Failure to fast correctly is the most common reason surgeries are postponed on the day. If you are unsure about anything, call the hospital or my rooms before the scheduled procedure.

The week before surgery

Alongside the medication and supplement restrictions above, the week before surgery is a good time to:

• Stop using medicated skincare on the face, including retinoids, salicylic acid, glycolic acid and benzoyl peroxide, as these can affect skin healing
• Avoid significant sun exposure to the face
• Avoid any facial treatments, injectables or cosmetic procedures
• Confirm your transport and care arrangements for surgery day and the first week of recovery
• Arrange time off work, since most patients need at least one to two weeks away from desk-based work

For a fuller picture of what the weeks after surgery look like, the rhinoplasty recovery timeline sets out each stage.

On the day of surgery

• Arrive with a clean face, no makeup, moisturisers or skincare products
• Remove all jewellery and nail polish
• Wear loose, comfortable clothing that does not need to go over your head; a zip-up or button-front top is ideal
• Do not drive yourself to or from the hospital

AHPRA requirements before rhinoplasty

Under the Medical Board and AHPRA cosmetic surgery requirements, several steps must be completed before any cosmetic rhinoplasty can proceed:

• A referral from your GP or another medical practitioner
• A minimum of two consultations before surgery is scheduled
• Screening for psychological suitability, with referral for assessment where indicated, and a mandatory independent assessment for patients under 18
• A cooling-off period before consent, at least seven days for adults and three months for patients under 18

These are regulatory requirements, not optional steps. My team coordinates each stage with you throughout the process.

Frequently asked questions

How long before rhinoplasty should I stop taking ibuprofen and aspirin?

Stop all anti-inflammatory medications including ibuprofen (Nurofen) and aspirin at least two weeks before your rhinoplasty date. These reduce blood clotting and increase the risk of bleeding during and after surgery. Paracetamol (Panadol) is a safe alternative for pain relief in the lead-up. If you take aspirin or other blood thinners for a cardiovascular condition, discuss the timing of stopping with both my team and your prescribing doctor well in advance of surgery.

Do I need to stop fish oil and supplements before rhinoplasty?

Yes. Fish oil, omega-3 supplements, vitamin E, garlic supplements, ginkgo biloba, ginseng and St John’s Wort all affect blood clotting or interact with anaesthesia. Stop these at least three weeks before your surgery date. If you take a multivitamin or any other supplement regularly, bring a complete list to your pre-operative appointment so my team can advise on anything else that needs to be stopped.

How long before rhinoplasty do I need to stop smoking?

At least eight weeks before surgery. Nicotine constricts blood vessels and significantly impairs tissue healing, increasing the risk of wound complications, prolonged swelling and infection. This applies to all nicotine products including cigarettes, vaping, patches, gum and lozenges. I may postpone surgery if nicotine use is detected at or before the operation. Stopping as early as possible, ideally from the time you book surgery, is strongly encouraged.

Can I drink alcohol before rhinoplasty surgery?

Stop alcohol at least two weeks before your surgery date. Alcohol affects blood clotting, interacts with general anaesthesia and post-operative pain medication, and impairs immune function during healing. Stopping completely from the point of booking through to the end of recovery is the approach that best supports your healing.

What happens if I eat or drink before rhinoplasty?

Eating or drinking before general anaesthesia creates a risk of aspiration, a serious complication where stomach contents enter the airway. For that reason, fasting instructions must be followed exactly. If you arrive having eaten or drunk within the restricted timeframe, surgery will be postponed. You will receive specific fasting instructions from my team and the hospital beforehand. As a general guide, no food from midnight and no fluids from two hours before surgery, but always follow the specific instructions you receive.

Consult with Dr Scott J Turner

Dr Turner consults for rhinoplasty in Sydney at Bondi Junction and Manly. Surgery is performed at Bondi Junction Private Hospital and at Delmar Private Hospital in Dee Why.

Contact the practice to arrange a consultation, or read more about Dr Turner’s background and training.