Is it normal to have a foul order after a septal perforation 4mm?

Hi there.  Thank you for your question.

There is no easy answer to this.  The nose area can be a very hard area to master.  This is one of the reasons why many plastic surgeons do not wish to handle this.  As for your question, you have to sit down with a surgeon who does a lot of rhinoplasties/septoplasties.  A dedicated surgeon would be your best bet.  Also many of the facial plastic surgeons are a good resource.  

As for your defect, it can be reconstructed with a new cartilage graft, or a mucoperichondrial flap.  I say this as a generic answer.  You have to see the surgeon and get them to take a very close look at your internal anatomy.  As for the smell, it could be that you either have an infection, or an area that has dessicated is simply dry.  The dry tissue can be rectified by an gel or an ointment dressing.  The infection needs to be addressed by an antibiotic.  Last but not least, it could be that the smell is something that only you detect.  This could be due to the fact that there may be some effects after the nasal surgery to the area of the ethmoids, and that can affect your sense of smell.

This is a hard question to answer.  I hope the brief explanation is helpful.