What can be done about hard septum cartilage lump years after removing piercing? (photo)

This could be from cartilage damage or cartilage infection or surrounding soft tissue infection. You will need to see someone to evaluate the actual cause. It can probably be cut out and corrected surgically.

Best Wishes,

Gary Horndeski, M.D.

Based on your narrative, I presume that you did not have previous rhinoplasty surgery. The bulge that is visible inside your right nostril looks like it could be a deviated nasal septum. If it's simply appeared after the piercing, it's conceivable that there is scar tissue in this area. If that is the case, perhaps a steroid injection might be helpful. And examination will be necessary to determine the cause of this bulge and nostril asymmetry. Wishing you well moving forward. Sincerely, Dr Joseph

There may be some scar tissue from the piercing. It could be trimmed back pretty easily if it’s painful