Nasal septum reconstruction, in addition to repairing the nose, focuses on the nasal cavities, or in other words, the middle third of the face. These elements affect important functions such as:
- Breathing, as it is the entry point for air and the space where the air is conditioned before passing to the lungs.
- It also plays a significant role in the olfactory and gustatory senses, or in other words, in nutrition.
- Finally, it also has a fundamental role in phonation, that is, in how we speak. If we do not have proper nasal cavities, we will experience voice distortion, not only when speaking but also when perceiving it. This inevitably affects communication between individuals.
Causes of Nasal Septum Destruction
There are various reasons why someone may need nasal septum reconstruction, and different degrees of destruction can occur. However, in the developed world, the main cause is addiction to certain drugs, such as cocaine. This drug causes vasoconstriction of the vascular plexus of the septum and nasal cavities, which in the most severe cases leads to the complete destruction of these structures.
Consequences of Cocaine on the Nasal Septum
When we talk about the nose, we typically only think of the pyramid-like structure that defines the aesthetic of a person’s face. However, it is also the entryway to a complex tunnel filled with intricate structures, vascular systems, and nerves that provide vital information to the brain and enable the most important function in our body: breathing.
Cocaine use causes constriction of the arterioles that carry blood to the mucous membrane and the nasal septum. As a result, these areas literally begin to die—technically, they become necrotic—and are destroyed. In such cases, we can observe how the patient’s facial structure gradually changes:
- The nasal pyramid begins to retract, causing the nose to collapse.
- The voice changes.
- Patients lose sensitivity in the nose, along with their sense of smell and taste.
Is Nasal Septum Destruction Reversible?
Once necrosis of the cartilage and mucosa has occurred, they cannot spontaneously regenerate, meaning there is no natural reversal. The solution in this case is a septal reconstruction, which is a complex surgery that also involves the reconstruction of the floor of the nose.
How is Nasal Septum Reconstruction Performed?
It is a microsurgery performed in several stages, due to the complexity mentioned earlier. This process typically takes around one year, during which multiple interventions are carried out.
We are talking about the reconstruction of the middle third of the face, and for this, tissue needs to be transplanted, which involves different phases, including:
- Placing the tissue
- Creating the structures
- Refining the volumes
- In many cases, also reconstructing the tip of the nose and the columella.
In conclusion, these are highly complex surgeries that require at least two to three interventions to achieve a result with which we, as plastic surgeons, are satisfied.
Changes That Matter: A Podcast from Clínica Planas
The podcast ‘Cambios que cuentan’ is a project created with the aim of bringing patients closer to the reality of aesthetic and reconstructive surgery, through real patient stories and the knowledge of our doctors. In the episode about Nasal Septum Reconstruction, Dr. Jaume Masià and Dr. Claudio Angrigiani discuss, from their experience, the difficulties of this surgery and the causes that may lead to needing it. When asked by Dr. Masià about who this episode of ‘Cambios que cuentan’ is aimed at, the doctor responds: “Obviously, it’s for all patients who are already in an advanced stage of nasal septum destruction. But it’s also for those who are starting their cocaine addiction, so they understand that this drug not only damages the brain, but also very important elements like the middle third of the face.”
