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What to do about the hole in my nose?

asked 1 year ago by JayHa in Las Vegas, NV
Latest answer by Jerry Lugger, MD
Question viewed 2,688 times
Tags: depression, hole, pre-op

Not really sure if this is the right place but I have a hole in my nose from doing cocaine about 5 years ago. This hole is growing in size even though I've stopped the drugs for over 3years now. My nose is falling apart and its really depressing me. What can I do to fix it, I know the cartilage wont grow back so for the last 1.5 yrs I've been putting Ayr nasal gel and petroleum jelly on the exposed cartilage. Now the whole nose is caving in on me and there is a hole the size of my index finger that can almost fit through from one side to another. PLEASE HELP in any way possible.

13 answers to What to do about the hole in my nose?

Nasal Septal Hole Secondary to Cocaine

Cocaine use compromises circulation to the septum which ultimately dies, causing the hole. Normal air flow through the nose will dry the mucosal edges of the opening which breaks down and the hole enlarges. This progression can be stopped by placement of a silicone disc or reconstructive surgery. You should take care of this in the near future.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Hole in the nose and nasal collapse

Dear Jayha: The hole in your nose is called a septal perforation, and it is not uncommon in cocaine users. If they are small and are not causing much of a problem, they can be treated symptomatically (with Ayr solution) or they can be closed with a small silastic "button" or surgery. It sounds like yours has become larger and more troublesome with some collapse of the nasal dorsum. In this case I would encourage you... more

Jerry Lugger, MD
Dallas Plastic Surgeon

Septal perforation and nasal collapse from cocaine use

You should have your nose examined by someone experienced with septal problems to see what's going on specifically in your nose. Cocaine use is a common etiology of such a problem. Depending on its size it may be amenable to closure. To address the outward changes to your nose cartilage grafting typically needs to be done. Seeing a board certified facial plastic surgeon or plastic surgeon with experience in fixing noses damaged by cocaine would be the way to go. more

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

Cocaine nose

Congratulations on no longer being on cocaine. It sounds like you will need nasal reconstruction wth a rib cartilage graft to support the nose. The septal perforation may be able to be repaired. Sometimes, depending on the symptoms and the configuration of the peforation it is better to remove some exposed carilage or bone to facilitate more stable healing of the mucosa. You should see an ENT physician or a double boarded ( ENT +plastic surgery) plastic surgeon or a plastic surgeon with... more

Ernest D. Cronin, MD
Houston Plastic Surgeon

Hole in the nose

A hole between the common wall of your nose is called a septal perforation. The size dictates treatment. when small (<0.5cm) surgical success is high and should be considered. When large (>2cm) the successful closure is poor and surgery isn't recommended. Medical treatment in the form of nasal washes and daily lubrication is better for most people. However for the collapse of the bridge of your nose surgery is helpful. Its a lot of reconstructive surgery and requires cartilage... more

Oakley Smith, MD
Toronto Facial Plastic Surgeon

www.droakleysmithrhinoplasty.com

Need to see an ENT surgeon ASAP

You should see an ENT surgeon ASAP for proper evaluation and instructions on performing nasal washes to prevent a chronic nasal infection. It's unwise to place any oil based product inside the nose as this can cause lipoid pneumonia if it gets into the lungs. Ayr is water based and would not be in this category, but petroleum jelly is oil-based.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Septal perforation and nasal collapse

Dear Jayha - thanks for your question - you have a very difficult problem but one that is reparable based on your description. The septal perforation repair operation and the reconstructive effort for the falling nose second to the perforation is the most difficult operation that we as Facial Plastic Surgeons do - finding a doctor with a good number of these operations under his or her belt is important. I would make no consideration for enlarging the perforation as this is... more

Paul E. Kelly, MD
Hamptons Facial Plastic Surgeon

Best Treatment for Cocaine Induced Nasal Septal Perforation (Hole) and External Nasal Collapse

Hi Jay, First thing that you can do is keep your fingers out of your nose, you won't be able to help, but you may make things worse. Second, relax and make a few consultations with experienced and skilled rhinoplasty surgeons. The hole (septal perforation) can be repaired if it is the size of your index finger, and the collapse of your external nose can be corrected with augmentation cartilage grafts. Cocaine is a very bad and addicting drug, glad that you are off... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Hole in the nasal septum after cocaine use

Unfortunately, this is a common problem for cocaine users. If the hole is small, there may be no symptoms except a whistling sound on inspiration. Large perforations tend to crust and bleed. However in the severly damaged septum, collapse of the nasal dorsum can occur. T his saddle nose deformity can best be treated with a rib graft

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

Septal Perforation closure may not be necessary

Few surgeons actually have a lot of experience with septal perforations (hole in your septum) and as a result finding someone who can help can be difficult. Luckily, we have a lot of expereince with this procedure and can help you determine whether attempting closure is possible or worth pursuing. In those case when the hole is very big and closure cannot be accomplished, patients can often have problems with the bridge of the nose or even the tip collapsing. In those cases, we can speak... more

Peyman Solieman, MD
Beverly Hills Facial Plastic Surgeon

Cocaine causes internal and external problems

I am happy that you are no longer on cocaine. Many users cannot stop, so you can be proud. Cocaine causes septal perforations by affecting circulation to the nasal lining. If there is exposed bone or cartilage, that can be trimmed back to reduce bleeding and rusting. The shape is another issue. Rib cartilage reconstruction is usually necessary to fix the upper lip, the bridge, and the tip. Select an experienced surgeon whom you trust and whose results in cocaine... more

Mark B. Constantian, MD
Nashua Plastic Surgeon

drconstantian.com

What to do about the hole in my nose?

Very difficult issue to correct. Seek in person advise and options from boarded PSs in Las Vegas. Surgery with grafts are the better options.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Nasal Septal Perforation due to Drugs

Septal perforations, when stable, can either be asymptomatic or cause problems with air flow. The former needs no reconstruction. Yours, however, sounds as if it is not stable, but progressive. If what you say is true, and you have cartilage actually exposed, this could be the reason for the progression. Usually, the hole will develop, the cartilage will die back beyond the edge of the mucosa (covering), and the mucosa will grow together side to side. If this has not happened, you probably... more