So about my nose...

[freakyschizogirl]

As many of you know I had reconstructive surgery on my nose earlier this year. Although the surgery was a success, i'm now having issues about the surgical button which was put in to plug the septal perforation.

Dr Jayne wants me to have it out as a foreign body and Wegs do not mix and it also poses an infection risk.

My ENT surgeon thinks I should keep the button in as risk of infection is lower than without it and easier to clean.

So now i'm torn, I was with Dr Jayne until I saw the ENT and now I dunno what to do. The procedure to get the button out will take all of 5 mins under local anaesthetic.

The Facts:
The button is made of silicone
I've had small bleeding and 2 nose bleeds since having the button in
The crusts seem to collect around the button making it difficult to clean
The button has been in 7/8 months now
I am now off all meds and had my last RTX in October



So my question is...what would you do?

[Debbie C]

That's a hard call.Would you just be left with a hole there or would something else be used? Even though anything they use to replace it will be "forgiegn" Didn't Dr. Jayne know about the surgery and what the plans would be ? Sorry but I don't know what I would do...if it's more problems than what it's worth than take it out.. Good Luck.

[annekat]

Hard to say, wish I could help. I know I have a hole in my septum but don't know how big it is. At the time of my biopsy 2.5 years ago, my ENT described it to me as "small", and he just said "keep it clean", meaning do lots of nasal rinses, have him clean things out periodically, etc. I hope someone who has had the reconstructive surgery will be able to shed more light.

[pberggren1]

I would ask your ENT to ask Dr. Lebovics in NYC about this. He is the top Nose Wegs doc around. I would be leaning towards your ENTs opinion though and not Dr. Jayne's. Just make sure you do your morning and evening rinses. I suggest getting a Waterpik and try that out. For myself and many others it is far superior to any other method.

[mishb]

I was going to say that I would lean toward Dr Jayne and not the ENT :unsure:

Dr Jayne is the WG specialist and probably the best in your part of the world, and I'm sure he knows what it what.

The button sounds like a pain to clean, something like when you first get a piercing done and you need to keep cleaning around it.
However, then the issue would be - what fills the perforation if the button is removed.

I'm sorry Sam, this can't be an easy and/or simple fix decision for you

[annekat]

Who did the surgery and put in the button? The ENT? I lean towards agreeing with Michelle, but not based on a lot of knowledge, more based on Dr. Jayne's expertise. I guess the hole would get filled with mucus, as is probably what happens with mine, since there is no button. I think sinus rinses may be instrumental in flushing that out. But I should probably get a Water Pik, as Phil suggests!

[mishb]

Phil better get a commission from the waterpik company I think :flapper::thumbsup:

[pberggren1]

Sam, do you want me to ask my doc about this? I see her on Monday so let me know and I will put in my notes.

[pwc51]

A really difficult dilemma - Rather you having to make a decision and possibly upset one or other of them is it possible for Dr Jayne to talk you ENT surgeon as they are the specialists and they can present their pros and cons to each other to arrive at a consensus? I know ... I live in Utopia!

[Alysia]

A really difficult dilemma - Rather you having to make a decision and possibly upset one or other of them is it possible for Dr Jayne to talk you ENT surgeon as they are the specialists and they can present their pros and cons to each other to arrive at a consensus? I know ... I live in Utopia!

not utopia but must. I also think, Sam, that your 2 docs should discuss it between them, maybe with more docs as well, something like case conference about you. you desreve it. it is their responsibility. it is not fair to make you decide. you can't decide, you are not a doc.

[freakyschizogirl]

Wow, thanks for all the responses guys.

Debra C I would just be left with a fairly large hole when the button comes out, there are no other options.

Annekat the ENT did do the surgery. Dr Jayne reckons the ENT wanted me to have the button because all surgeons are perfectionists lol.

Phil please do ask your doc, would be nice to have an unbiased opinion.

PWC51 and Alysia I think you are right, Dr Jayne said he would talk to my ENT but it seems he has forgotten, I don't blame him, he's a very busy man. But I will ring his secretary next week and ask her to remind him. And Alysia you're right its too big a decision to make on m own I don't want a big gaping hole but I also don't want this button in. I find it hard to believe there isn't another option for me.

[Alysia]

I can't believe that the button it the only option. since I asked the best ENT I have found in Israel about surgery for saddle nose, he explained to me that the best way to do it is by inserting cartilage taken from the ribs. if needed also a piece of bone from the ribs. it sounds that if they can use your own "flash and blood" maybe it can be better, maybe even with no hole. anyway, serious consultation must be set. please update us. sending you my hug.

[pberggren1]

Alysia, I don't think all saddle nose comes with perforated septum. Mines does not.

[Alysia]

Alysia, I don't think all saddle nose comes with perforated septum. Mines does not.

mine neither.

[pberggren1]

Oh, maybe I don't get what you mean then?

[Alysia]

Oh, maybe I don't get what you mean then?

If I understand well, the nasal septum separates the left and the right airways in the nose, dividing the 2 nostrils. WG can destroy it. But not in my case. I have "separate" nostrils. In my case, as far as I understood my ENT, WG destroyed the nasal dorsum which is the "bridge" of the nose. WG can destroy the bridge cartilage or also the bone. My ENT told me that my bone is (yet ?) intact.
but maybe I dont understand correctly so please tell me if I am wrong.

[pberggren1]

Okay, I thought you meant that all saddle nose came with a perforated septum.

[drz]

Using part of your body for repair is usually a good option. Most things inserted into body for repair are things that are inert things that your body should not react too like titanium or stainless steel or ceramic. But it can happen and in those cases the new repairs are also destroyed by same process that destroyed the original part or an infection results. I had this happen in past with some reconstructive ear surgery but my titanium implant is still doing OK and seems integrated into my skull. Some times they don't take and have to be removed. I know one person who has had 8 operations to try repair and replace his hip joints. Usually infection is the problem and not rejection but infection can be caused by rejection of foreign part.

[Psyborg]

Sorry you are having difficulty with your nose :( I hope they can come up with a good solution for your needs. Stinks when the doctors don't agree.

[annekat]

If I understand well, the nasal septum separates the left and the right airways in the nose, dividing the 2 nostrils. WG can destroy it. But not in my case. I have "separate" nostrils. In my case, as far as I understood my ENT, WG destroyed the nasal dorsum which is the "bridge" of the nose. WG can destroy the bridge cartilage or also the bone. My ENT told me that my bone is (yet ?) intact.
but maybe I dont understand correctly so please tell me if I am wrong. Well, now I'm a bit confused and will have to do some research. I wasn't really aware of the nasal dorsum as a separate entity. I'm under the impression I have at least a small hole in the bony part of what I thought was my septum, an that according to the ENT, it is pretty far up. I thought that the cartilage dropped because it lost its support at that point. But I think I still have a septum that divides my nose, whether there is a hole in it or not. I guess I thought the cartilage part of the septum was what formed the bridge and that it's dropping from lack of support was what caused the saddle nose. My ENT is kind of quiet and may not have explained all the details well. Obviously, every case is a little different.

[Alysia]

Hi Anne, I am not sure. need to check it. anyone knows ?

[pberggren1]

Sam, my doc said it is too hard to comment on cases she does not know. But she would tend to lean towards the ENT.

[freakyschizogirl]

Thanks for asking Phil. Now i'm still confused and not quite sure what to do.

[pberggren1]

I would get your ENT to consult with Lebovics on this one if you are not sure.

[mama2005]

I had my surgery two years ago and have really large hole in my septum my doctors chose not to do the button because of risk of infection. It does have to be cleaned out at least two to four times a day and still gets pretty bad. Hope this helps good luck.

[gilders]

I'd go along with what pwc51 says. Hopefully they will be best to voice each others concerns and come up with the best decision.