Revision rhinoplasty and perforated septum repair - combined surgery?

These two procedures can definitely be combined and it is very logical to have one operation to accomplish both goals rather than two. However, it needs to be done by someone who has experience doing this combination to produce a successful outcome.

This is definitely possible and would be optimal to do all at once for multiple reasons.  You DEFINITELY need to make SURE you find a surgeon who is a expert in rhinoplasty and especially septal perforation repair.  Septal perforation repair is highly specialized.  You need to find a surgeon whose main focus of their practice is nasal surgery.  I cannot emphasize this enough.  I do septal perforation (and rhinoplasty) closed now, which has multiple advantages.  It is tedious surgery that requires very high concentration with no distractions or time constraints. Most surgeons cannot commit to this level to assure consistent results.  Don't be afraid to travel to find this type of surgeon.  It will be worth it in the long run.    

Small perforations can be closed without major difficulties, and could conceivably be combined with revision rhinoplasty, but often additional cartilage is needed for the revision and that needs to be thought out and planned.  Larger septal perforations are complex procedures, and in that case the two procedures should not be combined.  Sometimes combining two complex procedures increases the risk of less than optimal outcome.

The open rhinoplasty approach is often used for septal perforation repair, so cosmetic changes can be made at the same time. There are limitations though. For example, Large perforations may not be able to be closed. Large hump removal may not be able to be closed. These are both difficult procedures. You should see a revision rhinoplasty expert for an opinion.

Absolutely, a revision rhinoplasty and septal perforation repair can be performed at the same time.  And, I strongly recommend that plan.  Be sure to see an experienced rhinoplasty surgeon to ensure the highest possible success rate.