Cocaine use can result in septal perforations (hole in the septum, or the partition dividing the nose into the 2 nostrils); because the septum is important for nasal support, large enough perforations can contribute to sagging of the nasal structures (and other problems such as crusting, bleeding, and whistling). Your photo suggest a deviation of the nasal axis to the right and left, in a C-shaped deformity. You would be best served with an in-person consultation and exam with an experienced rhinoplasty surgeon; during this consultation, the surgeon can evaluate your functional and cosmetic problems, and develop a treatment plan. You may require septal reconstruction and rhinoplasty, with possible cartilage grafting (from the ear or rib). Look for a surgeon with a keen understanding of facial and nasal anatomy and physiology, extensive experience with both cosmetic and functional septorhinoplasty, and ability to develop a good rapport with you. Good luck!