Recent Rhinoplasty and Now Hole in Septum. Doctor Says It May Close on Own?

Had primary rhinoplasty 16 years ago, the tip remained high so I the tip lowered and possible of repair uneven nostrils. I am 16 days p/o.The tip is lowering, the nostrils are still uneven & today, a small clot came out.I noticed a whistle & weird air feeling. I went to the plastic surgeon and sure enough I have a small hole in my septum. He told me things where still healing and to apply neosporin and it should heal on it's own? Is this true, he is well respected with 30 years exp. Help!

Doctor Answers 6

Septal perforation after rhinoplasty

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During the secondary procedure did you have sub- mucus resection (SMR)of septun or cartilage graft taken from it to cause septal perforation? You did not mention any such prodedure. Your prognosis  depends upon where the perforation is located . Perforations in the front part of the septum may have better chance of healing sponaniously.  Also size matters.

Los Angeles Facial Plastic Surgeon

Hole in Septum Post Rhinoplasty

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Regardless of size, it is unlikely the septal perforation will heal on its own. Follow the instructions of your surgeon - you're only 2 weeks post-op. Ultimately, it is best to close the opening to avoid long-term problems.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Septal perforation will not heal on their own

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Sorry to hear about your nose. Septal perforations can occur in about 1-2% of primary noses. That rate can be up to 5% in revision noses. When a perforation occurs in the OR it has to be repaired at the time. When it is noticed in the post-op period it will absolutely not heal on its own. You really have two options. Let your nose continue to heal and perhaps the perforation will be asymptomatic. If not repair can be done but be sure you see someone that is very experienced with this. It is a tricky procedure and if not done right it can make the hole worse!

Benjamin C. Marcus, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 46 reviews

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Septal Perforations

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Septal perforations that are larger than 1cm in diameter will not heal on their own. Occasionally small ones may close but unlikely. Depending on the size you can have a mucosal flap repair. However, even a repair may still leave you with a perforation.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Septal perforation will not heal

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It is unlikely that the hole in your septum will heal.  However, it may not cause you any issues.  If the hole, if far enough back in the nose it may not cause any symptoms. 

Septal Perforation

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I agree with Dr. Slupchynskyj. Your perforation will need repair by moving healthy nasal lining to cover the hole. Dr. ES

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