Septal Perforation FAQs

Mr Hassan Elhassan is a Consultant ENT Surgeon with a specialist interest in rhinology, nasal and sinus surgery, revision surgery and septal perforation.

He is registered with the General Medical Council under registration number 6128082 and works in private practice in London as well as holding an NHS consultant role.

Mr Elhassan speaks English and Arabic.

Private appointments are available at selected London hospitals according to clinic availability.

The Contact page contains current clinic details and individual maps. Your appointment confirmation should always identify the correct location before you travel.

New-patient, second-opinion and revision consultations can be requested through the Booking page. Availability is confirmed by the team.

The Reviews page contains selected patient feedback, professional skill information and direct links to Mr Elhassan’s independent Doctify profile.

Doctify currently records a rating of 4.98 out of 5 from 232 reviews. Review totals can change as new feedback is published.

A septal perforation is an opening through the nasal septum, the structure that separates the left and right sides of the nose.

Some perforations cause few symptoms, while others are associated with crusting, bleeding, whistling, irritation or a sensation of nasal blockage.

Causes can include previous nasal surgery, trauma, repeated injury or irritation, intranasal drug exposure and, less commonly, inflammatory, autoimmune, infectious or other medical conditions.

The cause should not always be assumed. When the reason is unclear, further investigation may be appropriate.

Yes. Septal perforation is a recognised possible complication following procedures involving the nasal septum, including septoplasty.

A perforation after previous surgery still requires individual assessment because its size, position, tissue quality and symptoms can vary considerably.

Intranasal cocaine can damage the blood supply and tissues within the nose and is a recognised cause of septal perforation.

It is important to give your clinician an accurate history because ongoing tissue injury and the underlying cause can affect assessment and treatment decisions.

An established full-thickness septal perforation generally does not simply close by itself.

That does not mean every perforation requires surgery. Some remain stable and can be managed by controlling symptoms and maintaining the health of the nasal lining.

Some perforations remain stable, while others may enlarge depending on the cause, ongoing irritation, tissue condition and other individual factors.

Persistent crusting, bleeding or changes in symptoms are reasonable reasons to seek ENT review.

Possible symptoms include nasal crusting, dryness, recurrent bleeding, whistling, irritation, discomfort, discharge and a sensation of nasal obstruction.

Symptoms vary, and some people have a perforation with relatively few problems.

Air passing through an opening in the septum can produce turbulent airflow. In some perforations this creates an audible whistle during breathing.

Yes. Dryness, crusting and turbulent airflow around the edge of a perforation can contribute to recurrent bleeding in some patients.

Recurrent nosebleeds have other possible causes as well, so persistent bleeding should be assessed rather than assumed to come from the perforation alone.

Yes. A person may experience a sensation of nasal obstruction even though there is an opening in the septum. Altered airflow, crusting and other nasal conditions may all contribute.

Changes in smell can occur alongside nasal disease, but reduced smell has many possible causes and should not automatically be attributed to the perforation.

An ENT assessment can consider other contributors such as inflammation, sinus disease or nasal obstruction.

Some larger or more complex perforations can be associated with weakening of nasal support and structural change.

This does not happen in every patient. Any visible change in nasal shape should be assessed clinically.

Diagnosis usually begins with a clinical history and examination of the nose. Nasal endoscopy may be used to inspect the septum and surrounding nasal structures.

The clinician will also consider the perforation’s dimensions, location, surrounding tissue and possible cause.

Not everyone requires additional tests. Further investigation is generally guided by the clinical history, examination and whether the cause of the perforation is already reasonably clear.

If an inflammatory, autoimmune, infectious or other underlying condition is suspected, additional testing may be considered.

No. Treatment depends on symptoms, the perforation itself, the health of the surrounding tissue, the underlying cause and the patient’s priorities.

Some perforations can be managed with symptom-control measures or monitoring. Other patients may consider a septal button or surgical repair.

Depending on the individual situation, symptom management may include measures intended to maintain nasal moisture and reduce crusting or irritation.

Your clinician can advise which saline, humidification or moisturising measures are appropriate for you.

A septal button is a prosthetic device placed across the opening in the septum. It can reduce troublesome airflow through the perforation and may improve symptoms for some selected patients.

A button does not biologically repair the missing tissue, and not every patient finds one suitable or comfortable.

Several reconstructive approaches exist. Surgery commonly involves mobilisation of healthy local nasal lining to cover the opening, sometimes together with an interposition or graft material.

The exact approach depends on the perforation and the available tissue and should be discussed during consultation.

Suitability depends on more than the size of the opening.

Factors may include its size and position, symptoms, surrounding tissue quality, underlying cause, previous surgery, structural support and other individual health considerations.

It is not appropriate to give an individual patient a reliable outcome prediction from the website alone.

Results vary according to factors such as the perforation, tissue quality, cause, previous surgery, surgical approach and healing. Closure also does not automatically mean that every nasal symptom will resolve.

Your consultation is the appropriate place to discuss expected benefits, limitations and material risks in your own case.

Yes. Previous failed repair does not prevent someone from requesting a specialist assessment or second opinion.

Revision cases can be more complex because previous surgery may change the available tissue and anatomy. Whether another procedure is appropriate requires individual examination.

All surgery has potential risks. Relevant risks can include bleeding, infection, crusting, nasal obstruction, wound-healing problems, persistence or recurrence of the perforation, scarring, continued symptoms and the possibility of further treatment.

The risks relevant to a particular procedure should be discussed as part of informed consent with the treating surgeon.

Recovery varies considerably according to the procedure, complexity of the repair and the individual patient.

Initial healing may take a number of weeks, while tissue maturation and follow-up can continue for longer. Your surgeon should give you procedure-specific instructions rather than relying on a generic timetable.

Aftercare depends on the operation performed. Patients are generally given instructions about nasal care, keeping the nose clean and moist where appropriate, medication, activity restrictions and follow-up appointments.

Follow the instructions provided by your own surgical team rather than substituting general online advice.

Timing depends on the treatment performed, your work, your recovery and any procedure-specific restrictions.

Your surgeon should advise you when it is appropriate to return to work, exercise, travel and other activities.

Septal perforation repair is not automatically a cosmetic procedure. Whether external nasal shape is involved depends on the anatomy, structural support and the planned operation.

Any expected external change should be discussed specifically before surgery.

Yes. Video consultations can be requested for initial discussions and may be particularly useful for patients outside London or overseas.

A video consultation cannot replace every aspect of an in-person nasal examination, so a face-to-face appointment may subsequently be recommended.

No. Detailed clinical documents and photographs are not required merely to request an appointment.

If particular records or images would be useful for your assessment, the team can advise you what is required and how it should be supplied.

The currently published standard fees are £250 for a new consultation and £175 for a follow-up consultation.

Fees can vary depending on location, insurer arrangements or other circumstances, so confirm the applicable charge when your appointment is arranged.

Mr Elhassan is listed with a number of private medical insurers, but individual policy coverage and authorisation requirements vary.

Contact your insurer before the consultation and obtain any authorisation required under your policy.

Yes. Patients outside the UK can request an appointment and may choose to begin with a video consultation.

If travel to London is subsequently planned, wait for appointment arrangements to be confirmed before making non-refundable travel bookings.

No. SeptalPerforation.co.uk is not an emergency medical service.

If you have severe or uncontrolled bleeding, significant breathing difficulty or another urgent medical problem, seek appropriate urgent medical assistance rather than waiting for a website, email or booking response.