Unique perforated septum - is it worth fixing? (photo)

Question

As seen by two specialist I have a unique perforated septum. I have an anterior perforated septum, not at the septal cartilage but at the membrane between the septum and columella where there is no cartilage. One of the specialist called it a nose ring hole location. The hole is approximately 0.5 mm in diameter.Can it even be fixed due to the anterior nature? Not experiencing any symptoms but am worried about the development of a saddle nose or destruction of columella

Ronald J. Edelson, MD · Answer

Even small septal perforations can be difficult to repair. If it bothers you it is worth repairing. Just be aware that the surgery may not be successful, but it would leave you no worse off than you are now.

Ritchie Younger, MD · Answer

Seek out a Board Certified Facial Plastic Surgeon who regularly performs a huge volume of septorhinoplasty surgery- and you will find your answer. A methodical history followed by a careful nasal exam will quickly reveal  the degree of surgical difficulty, and your selected surgeon can easily describe what his or her game plan may be to achieve your goal. I see a lot of septal perforations, and having a hole in the lowest part (called membranous septum) is rare, but over the last 30 years I have surgically managed four, and because of the relative ease of access-results are very gratifying-100% closure rate.  Find an experienced surgeon in your area who may have the skill and technology to make your dreams come true....

Scott Trimas, MD · Answer

The bottom line is that can be easily corrected especially since it is toward the front part of your septum where there is more available tissue to rotate into the hole and close it. I would recommend seeing a facial plastic or ENT surgeon in your area. Saddling is unlikely to occur with that type of injury although you could develop some tip drooping or ptosis over time.

Hong Ryul Jin, MD · Answer

Such a small membraneous septupm perforation will not cause saddle nose deformity or columellar deformity. You can try fixing it if you have any bothering symptoms. Consult nearby ENT/facial plastic surgeons for this. Thanks.

Daniel Barrett, MD · Answer

Dear NewMe__2018,
it is hard to tell for sure without an examination. Based on your photos, it looks like this could be improved with surgery. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Unique perforated septum - is it worth fixing? (photo)

Answers (5)