Author Topic: Collapsed nose due to Cocaine use  (Read 11897 times)

Offline edwards5

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Collapsed nose due to Cocaine use
« on: June 20, 2012, 11:08:47 PM »
Hello,
   I found this site while looking for surgeons that may be able to help my brother. He is 27 years old and has been living the last 3 years with a collapsed nose due to cocaine use. We have had some surgeons say they can't help and one surgeon said he could. The one that said he could hasn't got back to us in 6 months so we are starting to look for other doctors. We live in West Virginia and are willing to travel. We are also hoping the doctor we find has some type of financial help system or payment plan.

Can you reccomend any doctors or give me advice of where to be looking?

Thank you!

Offline DrBermant

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Re: Collapsed nose due to Cocaine use
« Reply #1 on: June 21, 2012, 09:43:08 AM »
Hello,
   I found this site while looking for surgeons that may be able to help my brother. He is 27 years old and has been living the last 3 years with a collapsed nose due to cocaine use. We have had some surgeons say they can't help and one surgeon said he could. The one that said he could hasn't got back to us in 6 months so we are starting to look for other doctors. We live in West Virginia and are willing to travel. We are also hoping the doctor we find has some type of financial help system or payment plan.

Can you reccomend any doctors or give me advice of where to be looking?

Thank you!

Welcome to our group!

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

The collapsed nose from lost support after cocaine use is one of most complex problems of nasal reconstruction.

A hole in the septum is a common complication from cocaine abuse. The drug may make the user high, but it is also a potent vasoconstrictor (makes blood vessels contract). The hole also no longer has tissue to absorb the drug so other areas get affected. As enough support is destroyed, the nose can collapse.

The nose is designed for breathing and protecting your lungs by humidifying the air. As the lining of the nose is destroyed, these functions do not take place as well. Other complications can result. The best choice: prevention, stop the use of this drug. Once the disaster befalls, then the true horror begins, living with the issues of the hole such as whistling, crusting, and irritation. Once there is nasal collapse, there is also difficult getting air to travel through the nose, having to be a mouth breather, and then appearance.

Each problem can exist to different degrees, from minor tiny holes, to wide defects, to slight to major collapse and deformity. Problems can progress over time.

In treating such issues the first step is stabilizing the problem. Septal perforations can have many different causes. Treatment without addressing the underlying issue tends to lead to recurrence. Self induced causes like cocaine at least have a chance of stabilization or in the case of cancer, at least removal of the involved tissue. Other problems like lupus and other autoimmune diseases are not as fortunate, and need to be optimized at least but because the problem is not solved, have a higher chance of recurrence.

Others have had similar concerns and we have provided old Message Board for Patient's Questions and Answers Septal Perforation, Septal Hole, and Hole in Septum.

Some septal holes can be reconstructed. The collapsed nose robs the reconstructive surgeon of tissue for the reconstruction. Mucosal flap repair sometimes is no longer an option as the nose collapses. Only an examination by a competent surgeon ENT or Plastic Surgeon who is comfortable in this region will be able to tell you if surgical intervention will be an option.

My practice moved on as I further specialized in other areas as discussed Septoplasty Nasal Surgery Forum - Septal Perforation. Trying to find someone with these skills can be difficult as the problem becomes less common and as the degree of difficulty gets harder.

We have resources here on How to Pick a Plastic Surgeon. But there are problems better managed by subspecialists.  Which is why I have been developing more specific guidelines for each problem. My how to pick a rhinoplasty surgeon guide has yet to be written. But beyond that there are some specializing in Septum Reconstruction and others in Nasal Collapse Reconstruction.

In this case one is looking for before after pictures of nasal collapse after septum perforation. Once variant is called the "Saddle Nose Deformity." At least it is easier for the surgeon to show the external factors with pictures. Documenting the degree of success of septal repair and reconstruction is more difficult, but can be done. Airflow through the nose is another factor that can be measured and documented. Someone who really has a passion for this problem should consider having these degrees of documentation for their own analysis of what they are achieving and to demonstrate to other doctors and the world what they are able to achieve.

Over the years I have scanned the internet for efforts at public education into various problems. Septal perforation and nasal collapse have been among these that I have looked for. Septal Perforation Repair is something I just found, yet I only saw one before after picture and it is not defined as coming from the same patient. I include the link not to endorse the doctor or possible skills, but at least someone is tackling the educational aspect of the problem.

But nasal collapse is a more complex problem. Analyzing this sculpture, needs to go beyond just pictures on the outside.

Is the nose still able to function as a nose? 
Can air pass through it?
Is the nose able to humidify the air?
Is smell functional?
And to each of these questions to what degree. It looks nice having a structure on the face. But it is even nicer when that structure is functional!

This forum was designed for those with concerns to have a place to put them. Your brother is welcome to post his concerns. It is rare to find someone sharing Standard Nose Pictures for the specific problem of cocaine complications for the obvious reasons. That also complicates finding a surgeon able to share such images labeled that way.

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
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