A septal perforation can cause crusting, nose bleeds, and even whistling. I believe that repairing a septal perforation is technically, the most difficult type of nose surgery. A rhinoplasty approach is typically used when repairing a septal perforation. The mucosa, or skin lining of the inside of the nose is elevated below and above the perforation and advanced to close each side. A piece of fascia or skin substitute is is placed between the two flaps to separate them. I like to use some fascia from behind and above the ear in the hairline.
Cosmetic changes with rhinoplasty can be made to the nose at the same time of a septal perforation. However, ear cartilage may need to be used for grafting purposes as there is obvious lack of septal cartilage due to the septal perforation.
Dr. Funk is a rhinoplasty specialist in Houston, TX. He performs rhinoplasty(nose surgery or nose job), septoplasty, and sinus surgery on patients from Katy, Sugarland, Houston, and Spring Cypress.