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Septal Perforation and Stuffy Nose After Rhinoplasty?

I had Rhinoplasty on 5/8/09. I have a hole inside my nostril but it does not go through. Is this septal perforation? Will it heal on its own? What can i do to help it heal? Also, I feel as if I have a stuffy nose all the time now, is this normal?

Doctor Answers (8)

Septal Perforation and stuffiness


It is normal to have stuffiness for a while after rhinoplasty. However, the hole in your nostril which does not go through and through does not sound like a septal perforartion. A septal perforation is a hole in the nasal septum (the wall inside the nose which divides the nose into right and left halves) and it always is through and through. Nostril is the fleshy part of the end of your nose. A hole in the nostril from a rhinoplasty is very unusual. You should definitely see your surgeon and get evaluated.


Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Septal nonperforation?



It is difficult to appreciate what you are describing without examining you.  If there is a hole that does not go through to your other nostril, then you do not have a septal perforation.  See your surgeon for a diagnosis and guidance as to how to enhance your healing.  Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 32 reviews

Best first to visit your surgeon



It's not abnormal to feel a bit congested for a few weeks after surgery but since you are describing a "hole" that "does not go through," I would recommend you make an appointment to see your surgeon to see what is going on. At the same time it is important that you not go around poking inside as you may cause damage or create a problem. I've taken the liberty of including some information on septal perforation, but first it's important to find out what is going on.

Having trained with the foremost experts in septal perforation repair, we have helped patients with this very complex problem.

What is a Septal Perforation and Why Do You Have One?

You probably already know that your septum is the wall between your nostrils that separates your two nasal passages. This structure is composed of cartilage in the front and thin bone in the back, and it has an overlying layer on both sides made of mucosa (the nasal lining). So, for you to have a septal perforation, it’s not simply a one layered hole; all three layers- the cartilage, and the lining on both sides have been damaged.

How did this happen? The reasons for a perforation vary and can be multifactorial. It’s true that septal perforation can and does occur from snorting cocaine and/or occasionally other drugs, but it can also be a result of previous surgery - like septoplasty or rhinoplasty, trauma to the nose, excessive use of nasal steroids and/or nasal decongestants like Afrin, as well as a host of other medical problems ranging from Wegeners disease, Sarcoidosis, Tuberculosis, Cancer, or Syphilis. We have even seen cases of excessive nose picking causing a septal perforation. The point is, once you are noted to have a perforation, the first thing to do is to get evaluated to determine the cause and the extent of the problem.

So, the Next Question is; What Problems are Caused by a Septal Perforation and Do You Need Nose Surgery to Repair it?

When you have a hole in your septum, the airflow through your nose becomes irregular. As a result, your nose dries out more quickly, causing crusting that obstructs your breathing and that may cause bleeding when the crust falls off. You may also experience recurrent or chronic infections and you may notice a whistling noise as you breathe. If you think about it, youll realize how this process can spiral downwards and exacerbate the situation considerably. The tendency, with the chronic cycle of crusting and bleeding, is for the hole to grow larger and larger over time. And, as the perforation becomes really large, you may begin to see collapse of your nose.

I hope this helps answer your questions.


Peyman Solieman, MD
Beverly Hills Facial Plastic Surgeon
3.0 out of 5 stars 3 reviews

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See your surgeon!


It is common to feel stuffiness one month after rhinoplasty. Rest assured. In addition, if you can feel a hole that does not go to the other side, then it is likely not a septal perforation. In either case, please see your surgeon and let them do a good examination and guide you. You should NOT be trying to look and feel inside your nose at this time. Good luck!

Sirish Maddali, MD
Portland Plastic Surgeon

Hole in nose


If there is a hole( or possibly a tear in your nasal mucosa) and not a hole all the way through, then you do not have a septal perforation, You may have had a tear of the mucosa which usually heals on its own if it is small. Let your doctor evaluate it, and do not manipualte it in any way.  Good luck.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Rhinoplasty, What the Heck is the Hole in the Nostril, and Why the Stuffiness?


Hi Chaos,

A septal perforation is a hole through the nasal septum (center divider of the nose between the nostrils). You should visit your rhinoplasty surgeon and point out your concern.

You should not be putting "things" into your nostrils (e.g. fingers) to know that you have a "hole that doesn't go through", nor should you be stretching you nostril to have a look inside. Speak to your surgeon about your stuffiness as well.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

You should visit your doctor


 Your surgeon will know exactly what's going on by examining you.  This would be the best way to get some answers since none of us can really say anything without examining you.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

A septal perforation could be easily diagnosed with a nasal examination.


Without looking in your nose, it would be impossible to make this diagnosis. Septal perforations can happen with nasal-septal surgery. If they're small, you may notice a whistling sound when you breathe. If they're large, you may accumulate alot of crusting.

Certainly bring this to your surgeon's attention. You could also seek consultation from a board certified ENT.

Best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 287 reviews

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.