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Septal Perforation Repair

The nasal septum refers to the thin structure of cartilage and bone that divides the right and left nasal cavities. It plays a critical role in both the appearance and functionality of the nose. While the septum helps to define the nasal tip and serves as a support for the structure of the mid-nose, it also contains sensory tissues that allows for optimal smelling function. When this important nasal structure suffers damage or perforation, it can cause distortion in how the nose looks as well as impact how a patient smells and breathes. To correct this, Dr. Ransom proudly offers septoplasty as part of our comprehensive menu of plastic and reconstructive surgeries for the nose. Septoplasty is the surgical modification of the structure of the nasal septum, which often involves straightening it, repairing a fracture or removing spurs (tissue blocking the nasal passage).

What Causes Septal Perforation?

A hole in the septum, or perforation, can occur from several different factors, including external nasal trauma in which the nose may not actually be broken. This occurs when a patient develops a septal hematoma (collection of blood within the septum) after the injury. If left untreated, the hematoma may cause the septum to perforate or collapse. A collapsed nasal septum often produces a saddle nose deformity that can have lasting consequences. Complications from a prior nasal surgery (rhinoplasty, septoplasty or sinus procedure) can also result in a delayed development of septal perforation. Lastly, some patients suffer from septal damage from chronic use of nasally inhaled medications and certain illicit drugs.

Repairing A Damaged or Perforated Nasal Septum

Septal perforations can result in a sensation of nasal obstruction, chronic nosebleeds (epistaxis), recurrent infections and an audible sound during normal breathing. While surgical repair can be challenging, Dr. Ransom is considered an elite rhinoplasty surgeon who uses special surgical techniques to maintain a high success rate with this type of procedure. To fill in the hole within the septum and promote healing of the surrounding nasal tissue, Dr. Ransom uses a multi-layered repair. This includes a layer of a patient’s own connective tissue (fascia) to rebuild each side of the septum, as well as a central layer that is more rigid and comprised of PDS flexible plate (Ethicon). This is a thin sheet of polydiaxonone, a material used in long-acting dissolvable suture. It is customizable in shape and size and considered highly effective for nasal septum repair. Depending on a patient’s unique needs, Dr. Ransom can perform septal perforation repair using an open or closed approach.

As a nose surgery specialist, Dr. Ransom offers the unique advantage of addressing both the internal and external concerns of the nose. While functional rhinoplasty is not considered a cosmetic surgery, Dr. Ransom can use a comprehensive approach to ensure that any desired or necessary cosmetic changes to the nose are added to a functional nasal surgery, including septal perforation repair. We realize the importance of helping patients feel confident in the appearance of their nose while also enabling them to breathe better.

What to Expect

When undergoing septal perforation repair, you will not be sent home with packing in the nose, which can significantly improve the recovery experience. Septal stents are used bilaterally to protect the repair and should remain in place for 7 to 10 days following your procedure. Patients can expect limited pain and occasional spotting, but any heavy bleeding should be reported promptly. It is also normal to feel tired for a couple days after surgery and adequate rest is important to your healing process.

For more questions about septal perforation repair at the San Francisco Center for Facial Plastic, Reconstructive & Laser Surgery, please contact us today to schedule a consultation. Keep in mind that while many insurance providers will cover nasal surgeries that involve functional improvement to the nose, insurance does not pay for cosmetic changes. However, cosmetic alterations can be added to septal perforation repair. Dr. Ransom is in-network with most major PPO plans as well as Medicare. We are happy to answer your questions about your benefits or about the procedure itself.


Based on 100+ reviews

Christina G.
I had several nasal/sinus issues including a severely deviated septum and a dorsal hump, which I wasn't crazy about. Dr Ransom did both the medical and aesthetic parts of my surgery and he did a wonderful job! While I did have some swelling, I didn't experience much bruising at all. I loved that he left the natural look of my nose just making small corrections. My breathing has GREATLY improved. His office staff was super helpful in scheduling and making sure payment and everything was very clear. I am very, very, very pleased with my results!!
Tk I.
I had a terrible surf accident in Bali and needed to get 50 stitches to repair what the reef did to my face. I had emergency cosmetic surgery in Bali the day of the accident. Immediately when i got back to the states i was introduced to Dr Ransom through some mutual friends. I was searching for the best cosmetic surgeon in San Francisco to help in my recovery. He and his team have been amazing! he helped establish a plan for my post-op wound care/treatment and administered some initial laser treatments. Dr Ransom and his team are extremely knowledgeable and very patient / helpful. I am very grateful for their help and support. I am finally looking normal again!
Joey B.
I had three issues with my nose - which inhibited my breathing: 1- broken nose, 2 - narrow nostrils that collapsed when I inhaled through my nose, 3 - deviated septum. When I was living in New York, I went to see a doctor about my breathing issues, and he said my skin was too thin and there was likely nothing he could do to rectify the problem. Dr. Ransom was recommended by an ENT I saw through One Medical. As soon as he saw him, he said he could easily fix my nose, and remove the bump that had formed from the trauma. His confidence and strong sense of self immediately put me at ease, and I had little doubt that he could accomplish exactly what he promised. He showed me a modified picture of my nose , and really liked what he proposed. The end result very closely matched what he promised. Not only can I now breath much more easily through my nose, it looks much better. He managed to make it look like an improved version of itself, however I still look like me, and unless I tell anyone I had it done, it's not overly noticeable, which I prefer. I'm pretty vain and very critical, and I can say that Dr. Ransom is great, and comes highly recommended.
Edward T.
Doctor Evan Ransom took my surgery on relatively short order and did a wonderful job. He is very talented and has a nice friendly professional support staff. I can not thank him enough, he was calm, caring, professional and interested in the follow results of his work . He seemed to bring a certain artistry to the profession.
Lisa C.
Dr. Ransom is a talented physician. He is knowledgeable, professional and goes the extra mile to make you feel comfortable during your treatments. He has been blessed with an artistic eye which brings wonderful results. I highly recommend Dr. Ransom and would refer all of my friends and family members to choose him as their physician.
Cheryl H.
Dr Ransom is very kind, honest, and conscience doctor. I was referred by my best friend, she is also Doctor Ransom patient. She has so much good things said about Doctor Ransom. So I had a face lift done by Doctor Ransom on July 2015. He did a wonderful job on my face and I have a lot of compliments on my face. So if anyone want to get their face done. I would highly recommended Doctor Ransom to you. I give Doctor Ransom a five stars.
Jill P.
I have currently been getting botox regularly with Dr. Ransom and he does a fantastic job. My previous doctor's office moved to another location where it was no longer convenient. I didn't realize what I was missing until I went to Dr. Ransom. I felt really comfortable, but most important he did a terrific job blowing my previous doctor out of the park. (Sometimes it's good switch it up a bit to make sure you are getting the best treatment.) On top of that, Dee the office manager is an incredible asset to the office. She personalizes your visit and relationship with the office to an extent I have never experienced before. I even get follow up calls to see how I am doing after a treatment. I highly recommend Dr. Ransom for his great work, and his team's impeccable customer service.
Arielle C.
Dr. Ransom and Dee are the BEST! Whether it's aesthetic or reconstructive, I'd trust him over and over again with my face.

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