Perforated Septum and Sunken Nose 20+ Years Post-Rhinoplasty. Causes?

Question

I developed a perforated septum after a severe bacterial sinus infection. After that, my nose sunk in and my face now has a flat effect. I have never done cocaine or any other drugs. I have been on prednisone for many years for rheumatoid arthritis. Are there any other causes for perforation and any causes for my nose to sink in? I'm assuming it's all related to the septorhinoplasty done in 1974 when I was 24 for broken nose and deviated septum. Will send photos if needed.

Thomas A. Lamperti, MD · Answer

It sounds like you have a saddle nose deformity. This can result from a septal perforation like you describe. Prior surgery can lead to a septal perforation, but other causes such at autoimmune disease, Wegener's disease, etc. should also be looked into as a possible cause of progressive worsening.

	Depending on the perforation size your septum may be able to be repaired. The saddle nose deformity may also be reconstructed as well. Check out my link below to see an example of this.

Anil R. Shah, MD · Answer

There are lots of potential causes of a septal perforation including:-trauma-previous nasal surgery-infections-nose picking or manipulations-granulmatosis disease-nasal sprays

Sam Naficy, MD, FACS · Answer

It appears that you have a saddle nose deformity - such as illustrated in the link below.  This is the result of loss of cartilage in the septum which can be caused by injury, medications, autoimmune diseases, or infection

Matthew Bridges, MD, FACS · Answer

BGT,

	One of the world's experts in repair of septal perforations is located in Houston, TX - Dr. Russell Kridel.  He is a master in treatment of septal perforation and rhinoplasty in general.  You should have him take a look.

Samson Lee, MD · Answer

Certainly having prior surgery is a probable cause for septal perforation and resulting saddle nose deformity. However other disease conditions should be excluded. Wegener's Granulomatosis is a disease that can cause septal perforation. Sometimes medicated nasal sprays could lead to this although that is very rare. Long term prednisone use may have had some role as well. You also want to have an examination in the nose to rule out any other potential causes.

Perforated Septum and Sunken Nose 20+ Years Post-Rhinoplasty. Causes?

Answers (7)

Answer: Septal Perforation

Answer: Septal Perforation

Answer: There could be multiple reasons

Answer: There could be multiple reasons

Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

Perforated Septum and Sunken Nose 20+ Years Post-Rhinoplasty. Causes?

Answers (7)

Answer: Septal Perforation

Answer: Septal Perforation

Answer: There could be multiple reasons

Answer: There could be multiple reasons

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.