The Cocaine Nose – Cocaine Nose Injury

No reconstructive surgery will be successful if the patient continues to snort cocaine. The first most important step is to stop any cocaine use.

In many ways the cocaine nose injury mirrors the process of the vasculitic nose. In fact it is interesting to note that cocaine itself can induce a vasculitic process in the nose that can continue well after the patient has stopped snorting cocaine.

Symptoms are mucosal bleeding, stuffiness and crusting in the nose and occasionally nasal pain. These are all signs of active cocaine use.

As the cocaine use continues, the cycle of inflammation and healing continues, the cartilage in the septum is weakened secondarily to the inflammation. This can lead to a septal perforation (hole). 

As this perforation (hole) enlarges it can cause weakening of the support to the middle portion of the nose and can result in a saddle nose deformity. To see saddle nose deformity click here Saddle Nose Deformity.

As the septum is progressively damaged, the saddle deformity can worsen and the nose becomes more shortened and the tip of the nose rotates upwards.

With further cycle of inflammation and healing, damage to the nose extends to the inner lining of the nose shrinking it through scarring and further shortening of the nose occurs. 

With continued use the columella (the bar of skin between your nostrils) of the nose can be eroded away. Click here to see columella reconstruction in a post cancer case.

The end result is a shortened nose with deficiencies in the inner lining of the nose and cartilage framework - Total nasal collapse

Total nasal collapse from vascultic disease 

With further use the hard palate can erode causing a fistula from the mouth into the nose. When this occurs liquid can leak from the mouth into the nose when drinking. 

Once the patient has stopped cocaine use these deficiencies of the inner lining of the nose cartilage framework and skin covering can all be reconstructed. The type of reconstruction will change depending on the severity of the deformity from Saddle Nose Deformity to columella reconstruction to Moderate Nose Reconstruction to Major (Nasal) Nose Reconstruction (partial nasal amputations or partial rhinectomy) and more.