Septal perforations can cause build-up of nasal crusting, obstruction, whistling noise and ocassional bleeding. Some of these issues can be improved with a nasal septal button. A septal button is a plastic splint that can be used to close the septal perforation, it can be done in the clinic with no downtime. Septal perforations can be fixed depending on the size of the perforation. The larger the perforation the more complex the repair and higher the chance of recurrence following repair. If the size of the perforation is > 1.5 cm, my suggestion will be to try a septal button if this is well tolerated it saves you a surgery and possibly multiple surgeries. If you unable to tolerate the septal button then consult with a surgeon who is comfortable repairing septal perforations.
Following any rhinoplasty there is going to be some swelling that takes time to resolve. It can take up to a year for the swelling completely resolve and the appearance of nose will change during this period. It is important to allow the tissue to settle before doing further changes. The tip of your nose will likely drop to point that you become pleased with the appearance. If you remain unhappy with the appearance it is still best to wait for things to settle before a revision.
Septoplasty generally does not change the external appearance of the nose. However if too much septum is removed it can cause the tip and nasal dorsum to collapse with time. A crooked nose will most often need a septorhinoplasty to straighten it and improve breathing.
