Is it possible to replace entire nasal septum?

Question

I went on a 4 month cocaine binge.. my entire septum is gone. I have stopped the use of cocaine.. so far the bridge of my nose is holding up although I have a tender spot near the tip. I've been using saline solution and Neosporin daily. Is it possible to replace an entire septum? They have a lot of congestion otherwise no problems I'm just worried my nose may collapse. What type of surgery is recommended and what is the cost. I know I have to wait a year. Any other suggestions for at home care

Scott Trimas, MD · Answer

I agree that you should wait at least one year for the blood supply to return. If you have a large septal perforation with absent septum, you may not need to replace that portion if the remaining dorsal and caudal strut (top and bottom) of the septum are intact and you may be able to provide additional support to your nose with either rib or ear cartilage. That being said if you have a saddle deformity (collapse of the top of your nose) then you may need more structural support with rib cartilage. I would recommend moisturizers and saline to minimize crusting and improve the overall health of your internal nose in the interim.

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well..based on your question it is difficult to evaluate your case without photos, my recommendation is a consultation in person with a certified plastic surgeon that sees you and evaluates what you need.

Thomas J. Walker, MD, FACS · Answer

Thank you for your question. Yes, it is possible to replace an entire nasal septum although this is an extremely difficult nasal surgery that very few surgeons perform. That said, it is quite unlikely that the entire nasal septum is gone from the cocaine use. There typically is some residual nasal septal cartilage (albeit not useful for grafting purposes) that can be supported with rib cartilage, which is not a total septal reconstruction but rather the residual septal cartilage (if present) can be supported with autologous cartilage (typically from the rib). You should see a revision rhinoplasty expert for a consultation, who also performs rib cartilage grafting. The cost varies greatly depending on the complexity of surgery, geographic location, surgeon, etc and hence cannot be answered on this forum. Candidacy for surgery also needs to be assessed during an in-person consultation along with expectations. Best wishes!

Is it possible to replace entire nasal septum?

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Is it possible to replace entire nasal septum?

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