Hi I'm 21 and I fell into a binge with coke for about 8 months .well just this nov I had scabs and yes I picked them or blew them out, well here comes dec and here comes the scab! I blew the hole thing out!! And I look up there with a flash light and there is a hole , I freaked out I'm very depressed over it and always worring about it, it's not too big but one side is bigger then the other! Please help! I have stopped using also someone please tell me how I can help this close! Thanks!
How To Treat Hole In Nose From Cocaine Use?
Doctor Answers 17
Hole in nose after cocaine use.
First of all you must stay off cocaine. Permanently. It is a potent vasoconstrictor that caused your nasal mucous membranes to die. Your body tried to heal from the alive edges, but more cocaine use killed more tissue (both sides) until the septal cartilage became exposed, dried out, and bacteria dissolved part of it (the part no longer protected by living mucous membranes). Hole results.
Reconstructive nasal surgery can be done, but this is not guaranteed and can fail as well. If even one use of cocaine happens, you might as well not have the surgery as you may cause an even bigger hole, collapse of the entire nose, and then you will really know what "freaked out" means.
I'd suggest professional drug rehab and prolonged and complete drug abstinence (tobacco as well, since nicotine is another major vasoconstrictor) for at least a year before even asking a rhinoplasty expert for surgical repair.
Surgical repair IS possible; the hole will NOT heal on its own (nothing you do or don't do will make a difference here except not making it worse with tobacco or more cocaine). So stay clean, don't pick any scabs that will form, and try to avoid blowing vigorously. Good luck!
Options in Treating Cocaine Nose Holes
Cocaine has 2 medical uses; it alleviates pain and is a very potent shrinker of blood vessels. As a result it was commonly used in nose surgery to reduce surgical bleeding and pain. Unfortunately it is EXTREMELY addictive and among its victims were many famous people including doctors (Sigmund Freud (father of Pasychoanalysis), William Halstead (father of modern American Surgery) and Sherlock Holmes).
Prolonged application of cocaine causes spasm and stoppage of blood flow in the septum followed by death of the lining followed by creation of various size holes with communication from one side to the other often with whistling on deep breathing. There is NO point in attempting surgery on anyone who is actively still using either cocaine or Neosynephrin. It is highly likely to fail. In such patients, cufflink like rubber prosthesis can be inserted plugging the hole. In others, reconstruction is done by using long flaps of nasal floor and septal lining that are rotated across the hole and stitched in place.
Septal perforation due to cocaine use
I hope this helps.
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Closing a septal perforation
Once a hole has formed in the septum (the wall between the right and left nasal passages), it rarely if ever closes on its own. There are many different options to close the hole including non-surgical and surgical management.
The single best advice is to go to surgeon who is well versed in closure. It clear from your post that you want this corrected as soon as possible, but you should ask around, do your research, and do not rush into the operating room. You should absolutely make sure you are free from cocaine use before any surgery is done.
Good luck from Manhattan.
Rebuilding a nose after cocaine use
Treatment is essential.
Sorry about your habit, and glad you are on the other side
You should find a plastic surgeon who has experience treating this, once you promise to yourself and the world that you will never snort cocaine again (or use it in any way). It requires a septal flap with mucosa and cartilage to fill the hole in some cases. If this isn't repaired, collapse of the nose can occur and it can look flattened over time. This is much more difficult to fix.
Septal perforation from cocaine use
Cocaine use - septal perforation
Let me start by encouraging you to try to stop PERMANENTLY using cocaine because the likelihood of success closing this perforation is very minimal if you keep using it. The reason being is the vasoconstrictive effect of cocaine that will almost always delays and causes the failure of the tissue to heal after your surgery.
As an ENT and a plastic surgeon, I highly recommend that you schedule a consultation with a well-experienced surgeon to address your septal perforation when he/she performs a good examination and explain to you the possible surgical options you have.
Please keep in mind that following the advice from a surgeon online who offers to tell you what to do without a physical examination covering the nature and the status of the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative solution would not be in your best interest. With that in mind, it is the safest and for your best interest to find a plastic surgeon with solid experience and certified by the American Board of Plastic Surgery who is ideally a member of the American Society of Plastic Surgeons that you will trust and be comfortable with. You should discuss your concerns with that surgeon in person.
Ali Sajjadian, MD FACS
Septal Perforation after cocaine use
The other option would be through surgery. It is usually done through an open rhinoplasty type of approach with very careful separation of the right and left sided mucosa that surrounds the perforation. Then we stitch each side of the hole (the left and the right) separately and place grafting material in between. This "sandwich" is quite successful in repairing septal perforations. Of course, the larger the perforation, the more difficult it is to get closed. It also goes without saying that patients need to be off of cocaine or else the repair will fail.
I hope that helps.
Michael M. Kim, MD
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.