What to do about the hole in my nose?
- Asked by JayHa in Las Vegas, NV
- 2 years ago
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.
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.
Web reference: http://www.drfpalmer.com
Hole in your nose is called a septal perforation
Septal perforations are holes in your septum. They can happen because of cocaine use, among many reasons. A surgeon with an ENT (Otolaryngology) background is a specialist in this problem and may be able to help you.
Hole in the nose and nasal collapse
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 to seek consultation with an experienced ENT physician, or with one of us that are double-boarded in ENT and plastic surgery. This can be improved but may take several surgeries, and the use of cartilage and rib grafts rather than any type of silicone like products for support of your nose. Good luck, and I would seek help as soon as possible
Recent Rhinoplasty Reviews
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.
Web reference: http://www.drlamperti.com/facial-plastic-surgery/rhinoplasty
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 special interest in nasal surgery.
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 harvested from either your ear or rib.
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 counter productive and I would also suggest that the reconstructive effort entail the use of no plastic, silicone or gortex materials. Your nose is currently living in a state of chronic low grade infection - the likely hood of these previously mentioned grafts getting infected is certainly higher than if cartilage grafts (rib) are used preferentially. The art of perforation repair is slowly dying so do your homework and choose one of us who performs this operation frequently - good luck.
Best Treatment for Cocaine Induced Nasal Septal Perforation (Hole) and External Nasal Collapse
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 of it. Good luck and be well.
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
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 to you about how we can build up the necessary support so that your nose can be stable and function long term.
Peyman Solieman, 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.