Can you receive surgery for septal perforation twice?

Thanks for the question. If you are symptomatic from your septal perforation (whistling, crusting, bleeding, trouble breathing), you should be a good candidate for closure of the hole. To repair septal perforations, I use a combination of an absorbable PDS plate and temporalis fascia, the covering of the bite muscle in the temple. This fascia is harvested through a small incision in the scalp, just above the ear. With this approach, I've repaired numerous perforations, even as large as 2 cm in size, with a >90% success rate. For small perforations like yours, it may be possible to close them through the endonasal approach, working just through the nostrils without opening the nose. For perforations over 1 cm in size, an open approach may be needed. The recovery is relatively easy with either open or closed approach. If necessary, additional procedures such as deviated septum surgery (septoplasty), valve repair, turbinate reduction, and rhinoplasty can be performed at the same time.Best regards,Dr. Mehta 

Small septal perforations that are asymptomatic should be observed and measured for size changes.  If the perforations grow in size or become symptomatic closure can be contemplated.  

It is not frequent but it may happen that patient with reconstructed septal perforation develops secondary defect. Most of the repairs will leave weaker tissue in the site of perforation which can easily be damaged with mild mechanical force like in your case.Waiting for spontaneous repair (moisturizing saline spray and gel) would be my suggestion. If perforation doesn't close within 6-12 months secondary repair may be considered. However, you have to find a plastic or ENT surgeon with significant experience in this type of surgery to help you. Good luck.

Hello PMcAleer,Sorry to hear of your recurrent perforation. Thank you for your information and questions. Unfortunately with out photos (or a physical exam) I can not provide you specific advice. However, I hope you find the following information helpful.Secondary repair of septal perforation is difficult at best because of scar tissue.In my experience secondary sepal perforations rarely heal by them self.Non surgical: septal buttonSurgical: 1)local flaps and grafts2)create a one chamber noseI recommend that you make several consultative appointments with Plastic Surgeons who are experienced in septal perforation repair and Certified by the American Board of Plastic Surgery. In addition ideally they are members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).I wish you my best and success,R. A. Hardesty, MD, FACSDiplomate and Certified by the Am. Bd. of Plastic Surgerywwwimagineplasticsurgery.com4646 Brockton AveRiverside, Ca 92506(951) 686-7600