Author Topic: Revision Rhinoplasty Forum - Septal Perforaton & Increasing Asymmetry Deformity  (Read 6112 times)

Offline DrBermant

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Dear Dr Bermant,

I have had an asymetrical nose for as long as I can remember that was caused by a fall when I was four or five.  It went untreated at the time and was barely noticeable until I hit pubert when it began to look more like a standard broken nose.

When I was 25 I had an operation on the septum to relieve breathing as my left nostril was almost entirely blocked with cartelage.  The surgeon cut out the cartelage but no realignment was done.  About a year later I noticed that a hole had deleloped in the septum.  The edges of the hole have always been a little raw but as the discomfort was minimal I did nothing about it.

Now I am 34 and the asymmetric 'broken' appearance of my nose seems to be getting more and more pronounced.  I'm considering having it reset with rhinoplasty as the lower left side of my nose has almost no cartelage supporting it and looks like it is collapsing in.  My question is considering the damage done to my septum by the earlier procedure is it wise to have more surgery, and if so what are the risks?

Many thanks!
This is something I am no longer offering in my practice as I have further specialized.

The forces on a bent nose can cause further deformity over time. Bent Nasal Deformity that combines problems of the septum and the nose, should have both corrected at the same time. Otherwise the septum is brought into the center of a structure that is not centered. To me it makes little sense bringing what may be a correctly placed septum to an off centered position just for breathing when addressing both structures both looks better an may have a longer lasting result.

Septal Perforations are particularly challenging. Closure is technically demanding and is not possible in some cases. Septal buttons are uncomfortable to wear. There can be many other issues at play such as a medical problem causing the perforation that needs to be managed. That is why having it evaluated can be so important before the hole enlarges further.

Rhinoplasty Risks, benefits, and alternate methods of care are best explored during a consultation with a doctor experienced with that particular problem.

Hope this helps,

Michael Bermant, MD
Learn More About Rhinoplasty, Septoplasty, and Sculpture
Michael Bermant, MD
Retired Plastic Surgeon
Surgical Sculptor, Artist, Creative Thinker, Problem Solver
Plastic Surgery
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