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How Do Drugs Cause Saddle Nose Deformity?

a nose covered with adhesive tape

The nasal mucosa (a mucous membrane in the nose) is easily accessible and rapidly absorbs liquid, powdered or aerosol drugs, making it a suitable medication delivery method. In addition, the effects of inhalation (snorting) are more potent and start more quickly because the drug does not have to go through the stomach and liver, where it would be broken down by digestion before reaching the bloodstream.

However, this delivery method is only beneficial when used short term. Prolonged and excessive insufflation damages nasal structures and may eventually cause a saddle nose deformity. This applies to over-the-counter medicine, prescription medication and illegal (recreational) drugs.

Therapeutic pharmaceuticals for intranasal dosage (decongestants, allergy medications and steroids) are dissolved in a liquid and sprayed directly into the nose. Other medicines not designed for intranasal dosage (pills) and recreational drugs are pulverized into a fine powder for insufflation.

How Does the Nasal Mucosa React to Drugs So Effectively?

Mucous membranes are found throughout the body (nose, eyelids, mouth, trachea, stomach, lungs and rectum). Their structures differ, but they all have one thing in common: a layer of epithelial cells connected to a sublayer of connective tissue. The epithelial cells are suitable for absorption and remarkably resilient, able to survive abrasion and other forms of wear that arise from environmental stresses.

What Happens to the Nose When You Use Internasal Drugs Too Often?

When medications are snorted, they constrict blood vessels, reducing the blood supply to the nose. As a result, the nasal bridge and the septum (the tissue that separates the nostrils) suffer damage. If a person snorts drugs daily, this damage accumulates over time and worsens because the body is not allowed to heal. This battering is frequently accompanied by local infection, exacerbating the situation.

There comes a point when the damage becomes so severe that the body cannot heal it anymore, and the external nose can become misshapen. Possible deformities include a collapsed nasal bridge (a saddle nose) and distorted nostrils. Another potential consequence of intranasal drug use is a perforated septum (a septum with holes in it). All these outcomes are often irreversible and require surgical repair.

What Can Be Done to Repair Nose Damage from Excessive Drug Use?

Rhinoplasty can repair aesthetic (like saddle nose deformity) and functional (like difficulty breathing) issues caused by drug abuse. Manhattan facial plastic surgeon Dr. Maurice Khosh specializes in rhinoplasty, particularly saddle nose repairs. You want a dual board-certified surgeon who has lots of experience with saddle nose surgery because it is one of the most challenging types of rhinoplasties to perform. Call Dr. Khosh for an appointment and, if necessary, a nose job that will be done well.

What Dr. Khosh's Patients Say


Based on 55 reviews

Meredith G.
Saw Dr. Khosh for a fractured nose. He reset my nose beautifully (and with little discomfort to me) and then discussed some of my sinus issues with me upon my follow up visit. Never felt like he was rushing me out and felt very confident in his abilities. I would highly recommend to anyone needing plastic or reconstructive options!
Jackie C.
Great front office, really good experience after what was a terrible accident. I was made to feel comfortable. Dr. Khosh is very good at what he does. I'm still healing but I'm confident of the results
Kaitlin M.
Dr. Khosh takes exceptional care of his patients. He has operated on me twice, each time making me feel extremely comfortable and satisfied with the results. His staff is also very kind and knowledgeable.
Diana G.
Dr. Khosh & his staff Susan & Christine are absolutely amazing! They were so supportive & helpful from beginning to end & they are just wonderful people. Thank you guys I truly appreciate everything you guys have done for me. I would recommend them to anyone & everyone!
Joann M.
After visiting and being evaluated by several doctors, I kept going back to Dr. Khosh. His tranquil spirit and professionalism were captivating. Thank you for a job well done and keeping me calm throughout the entire process. A special thanks to your staff Susan and Christine for all of their support as well. Hi highly recommend Dr. Khosh.
Leah G.
Upon hearing of the overwhelmingly positive experience a friend of mine had in choosing Dr. Khosh as her surgeon, I decided to make an appointment for my own septoplasty/rhinoplasty/turbinate reduction. Although I was slightly skeptical as the praise I had heard seemed a bit hyperbolic, all uncertainty dissipated after meeting the Doctor and his staff. My pre- and post-operative experience was excellent in terms of concerns adequately addressed prior to the surgery and mitigation of any bruising in the convalescent period. Despite my apparent predisposition to rather slower healing, a year after the surgery, my nose looks really pretty and my breathing entirely unobstructed! I highly recommend Dr. Khosh!
Courtney G.
AMAZING!!!!!! I had Dr Khosh perform lipo on my chin/neck and my result is unbelievable! Better than I could have expected! I met with a couple of surgeons and the second I met with Dr Khosh I knew he was the one I was going with. He was compassionate and explained every detail of what would take place during the surgery and what to expect during recovery. I even emailed a few times during recovery with various questions and he got right back to me asap which was really comforting! I honestly fully recommend Dr Khosh, he did an amazing job and is an amazing person.
Frieda S.
i can finally breathe!! Dr. Khosh made the entire experience a breeze, it was truly a pleasure to be under his care. I am forever thankful and highly recommend him. Not only does his work speak for himself, but he has excellent bedside manner. His kindness and patience is above and beyond. He takes the time to answer to every question you have to help you understand the process while at the same time making you feel so comfortable. From the first consultation i knew i was in good hands. I am so pleased with the result and forever thankful.
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Saddle Nose Repair
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