I have a large hole in my nose from cocaine. Can it be fixed?

Doctor Answers 8

Correcting Cocaine induced Nasal Malformations and Perforations Must Be Treated Carefully as Tertiary Rhinoplasty

The short answer is use, Cocaine induced nasal deformities and perforations can be reconstructed to regain the form and beauty of a natural uninjured nose.  The most important part of the treatment is actually recognizing the pathophysiology and treating the surgery as what experts in the field call "tertiary rhinoplasty."  Master level craniofacial surgeons consider any nose that has been operated on more than two times with unfavorable results a tertiary rhinoplasty.  This distinction indicates that vascullarity can be a significant issue and that complex reconstructive techniques and CAREFUL PLANNING are necessary for success.  The "Cocaine nose" is comparable to a nose that has been through seven plus surgeries in my experience.  The reason that the nose becomes destabilized and can develop holes or perforations is the long term damage to the microvasculature caused by repeated cocaine exposure.  

Any surgery on a nose damaged by cocaine must account for this, otherwise there is a high risk for total nasal loss or worsening of the problem.  Every repair must introduce healthy tissue and reliance in the damaged tissue must be minimized.  Of course every such surgery must be customized to the findings of the individual patient but commonly involves local flaps or more commonly in my practice, fat and stem cell grafting to restore tissue health followed by staged procedures.

Find a plastic surgeon with Craniofacial training and experience reconstructing tertiary rhinoplasties and listen to the options they present.  This unique skill set can protect you from many of the common disaster resulting from treating the "cocaine nose/"  I hope this helps!

All the best,

Rian A. Maercks M.D.

Septal perforation repair

In most cases, septal perforations can be repaired surgically using the remaining tissue within the nose. Septal "buttons" made of silicone can also be used to plug the defect. The main requirement is that you have no ongoing nasal drug use as that will ensure that any repair will fail. Seek a consultation to determine what options exist to repair your perforation. I hope this information is helpful for you.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

I have a large hole in my nose from cocaine. Can it be fixed?

The short answer is-- there're several techniques including a silicone implant that attempt to correct the problem. However, the success rate is very low and recurrence is likely. There is no hope for a permanent repair if the drug use persist. Therefore, complete and total abstinence is a requirement before attempting the surgery.

Septal Perforation from Cocaine use can be Fixed

Dear Micele, Cocaine use may cause a septal perforation which can be fixed. An examination will determine the extent of your perforation and then a surgical plan would be discussed. Make sure you see a surgeon experienced in this area. Best regards, Michael V. Elam, M.D. 

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 196 reviews

I have a large hole in my nose from cocaine. Can it be fixed?

As stated this is a drug induced septal perforation. Repair/reconstruction can be a very difficult operation. Best to seek many in person consultations. 

Cocaine induced nasal deformity

Many times cocaine will cause a septal perforation and nasal collapse. This can be fixed. Check with a plastic surgeon with experience in nasal reconstruction.

Eric Weiss MD

Eric Weiss, MD, FACS
Orange Park Plastic Surgeon
4.8 out of 5 stars 29 reviews

Septal perforation due to cocaine use

Large septal defects from cocaine use can be very difficult to correct.  Best to be check by a plastic surgeon or ENT who is experienced in dealing with this problem.  A smaller defect may be easier to correct surgically.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Septal Perforation

Hi Micele.  Medically, this is known as a septal perforation (the septum is the wall between the nostrils).  Septal perforations are potentially amenable to repair.  Without an examination, though, it is difficult to counsel you.  Variables include the size of the perforation and the quality of the surrounding tissue.  I hope this is helpful.  Regards, Anand Shah MD.

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.