Can I have a my Perforated Septum, Deviated Septum and Pinched tip all fixed at the same time? (photos)

I had my 1st rhino/septo '01 all was ok. Last 2 yrs i noticed changes. During a consult I learned I have 1.5 cm perf. toward mid of nose. Changes in nose appearance, & perforation started happening last 2 years. Nose looks pinched, left side slight collapse. Septum deviated. Also want to fix perforation. I consulted with doc in cali, he's willing to do revision, septo, fix perf. all at same time. Can i do these surgeries all at once? Would i benefit from cartilage to fix the pinched nose?

Doctor Answers 6

Can I have a my Perforated Septum, Deviated Septum and Pinched tip all fixed at the same time?

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      I have done tertiary and quaternary revisions, but the key is to only operate if a definite improvement can be made.  I would have to examine you to determine that a definite improvement could be made.

Kenneth Hughes, MD

Los Angeles, CA

Septal perforation and rhinoplasty

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Rosa, you should consider doing all repairs in a single setting. Your nose requires structural grafting in order to revert and prevent future collapse. Cartilage grafting and sources can be determined at the time of surgery, however, chances are you will require grafts from your ear or rib. These are obtained through small incisions, which are very safe and heal well. Please visit several rhinoplasty specialists and discuss their experience with revision surgery. 

Grigoriy Mashkevich, MD
New York Facial Plastic Surgeon

Grigoriy Mashkevich, MD
Manhattan Facial Plastic Surgeon
4.7 out of 5 stars 10 reviews


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Yes, you can have these issues all fixed in one surgery.  The septoplasty will involve a correction of the deviation and a mucoperichondrial flap to close the perforation.  For the pinched tip, additional cartilage is necessary.  If no septal cartilage is present, cartilage from the ear can be used.  

Revision septorhinoplasty combined with repair of septal perforation

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I think that not only it is possible to combine these three procedures in one setting, but also that it should be done all together as it makes sense to address all problems at once. 
You may need a cartilage graft to reconstruct your weak tip and collapsing right ala; this graft can be obtained from the ear or from the rib, depending on the quantity and quality needed. 

Alexander Ovchinsky, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 32 reviews

Revision rhinoplasty can be combined with septoplasty and septal perforation repair

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It's common to combine revision rhinoplasty with repair of a deviated and/or perforated nasal septum. The procedure can be complex but the surgical approach called open rhinoplasty is the same from the start.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Revision septal rhinoplasty and closure of perforation

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It is possible to do these combined procedures in one setting. You may require cartilage grafting which may have to come from the ear or rib

William G. Hart Jr., MD
Saint Louis Plastic Surgeon

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