2cm perforated septum. Do I have chance for successful surgery? Do you think my nose started to collapse?

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty and spreader grafts to help straighten your nose.  An examination with a nasal speculum could help determine the extent of a septal perforation.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Hello. Great question. Thank you for your questions. A personal examination is needed to properly address your concerns. Please schedule a consultation with a board certified plastic surgeon for a detailed surgical plan to achieve your desired results. 

Hello and thank you for your question and all your photographs.  Although an exam in person is ideal, from your photographs alone it appears that your septum is deviated and you would likely benefit from a septoplasty with bilateral spreader grafts.  Spreader grafts are cartilage grafts placed on either side of your septum -- they serve to both improve your breathing and stabilize/straighten the lower 2/3 of your septum, which is composed of cartilage.   You would also likely benefit from a tip rhinoplasty which would help straighten the lower 1/3 of your nose, the nasal tip which is composed entirely of cartilage, that can be modified, sutured, and reinforced... The next step for you is to find the right aesthetic plastic surgeon.  In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome.

After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to the link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS

Harvard-trained Board Certified Aesthetic Plastic Surgeon

Thsts a large septal perforation.  The risk of collapse with rhinoplasty depends on where the perforation is.  An intranasal exam can provide the answer to that and determine if you will have adequate support after rhinoplasty.

Your nose is definitely in need of some grafting with rib cartilage. Left to its own devices, I believe you will wind up with a collapsed, deviated nose. My opinion is that you should have a rib cartilage graft harvested to create dorsal reconstruction grafts, a caudal septal strut reconstruction, and lateral crural strut grafts.