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