septal perforation

septal perforation


London / Serbia: February 2019

Septal Perforation Surgery &

Septal Perforation Treatment Specialist

Dr. Jason S. Hamilton, M.D., Director of Facial Plastic and Reconstructive Surgery at the Osborne Head and Neck Institute is double board-certified in facial plastic surgery and otolaryngology/head & neck surgery. Dr. Hamilton specializes in the surgical septal perforation treatment and repair. He has pioneered new methods and equipment designed specifically for treating patients with septal perforations and has achieved one of the highest success rate at 99% for large and small septal perforations.

Dr. Hamilton’s unique technique has allowed him to consistently achieve superior results for his patients time and time again. He has one of the highest success rates in the world for closure of septal perforations and as such draws a diverse group of patients from across the globe. Dr. Hamilton practices in Los Angeles, California, at the Osborne Head & Neck Institute, Cedars Sinai Medical Towers. In an effort to educate patients about options for septal perforation treatment Dr.Hamilton holds quarterly patient conferences for surgical candidates suffering from septal perforations in: New York, Chicago, Orlando, and Texas.

Dr. Jason Hamilton

Dr. Jason Hamilton, MD, FACS
Septal Perforation Specialist

Dr. Hamilton and Dr. Osborne discuss the surgical options for a complex septal perforation case.


Septal Perforation Repair for Patient with Hereditary Bleeding Disorder

HHT is a hereditary condition that causes fragile malformed blood vessels. After many trips to the emergency room to cauterize and stop nose bleeds, David is left with a large hole in his septum that must be fixed.



septal perforation

A septal perforation is a through-and-through hole in the central partition of the nose (nasal septum). Septal perforations are caused by insult or injury to the septum.


septal perforation

The most common causes of septal perforations are prior surgery, abuse of topical nasal sprays, or illicit drug use. A perforation is diagnosed by nasal rhinoscopy.


septal perforation

Dr. Hamilton has designed several treatment plans based on individual patient goals. Dr. Hamilton’s goal is to make the nose functional and the patient symptom free.


septal perforation

Dr. Hamilton is an expert in septal perforation repair with a success rate over 99% for large and small perforations. Call today to schedule your evaluation.

Frequently Asked Questions

Q: What is a Septal Perforation?

A: The septum is the central divider within the nasal passage responsible for even airflow through the nose. A septal perforation is a hole in the nasal septum, typically caused by and injury to the delicate mucosal lining of the nose. It is made up of very thin cartilage and bone, and covered by a delicate mucosal membrane. Septal perforations occur most commonly from an insult to the septal mucosa, which supplies blood, oxygen, and vital nutrients to the underlying cartilage. After significant injury to the blood supply of the septum the cartilage dies and leaves a hole. As the whole increases in size symptoms begin and increase in severity. The most common injuries causing septal perforations are nasal fractures and trauma, prior nasal surgery and abuse of nasal medication or illicit drug abuse.

Q: How Is A Septal Perforation Diagnosed?

A: Dr. Hamilton can diagnosis your septal perforation by a routine nasal exam and/or nasal endoscopy. Many patients also make self-diagnoses at home or are referred by another physician for treatment. After the perforation is diagnosed, it is then important to determine the health of the remaining septal mucosa and discover the cause of the septal perforation. Knowing the true etiology of the septal perforation is paramount to effective septal perforation treatment planning by Dr. Hamilton. To have a successful treatment we must know the cause of the septal perforation to prevent further recurrence after surgery. This is especially true for patients with undiagnosed autoimmune disorders, HHT, patients with compulsive behavioral habits (i.e. nose picking) and those with a history of medication or illicit drug use. The most important thing to keep in mind after being diagnosed with a septal perforation is that advanced treatment is available, but only through a septal perforation specialist, such as Dr. Hamilton. Remember, mismanagement is common, and includes; being told that there is nothing that can be done, advice to watch and wait for spontaneous closer, and treatment of smaller perforations with a septal button, which instead could be simply closed by Dr. Hamilton. Patients seek out Dr. Hamilton for advanced treatment options for their septal perforation treatment needs.

Q: When Should I Seek Treatment For Septal Perforation?

A: Complications are Associated with Septal Perforations
The nasal septum stabilizes the nose much like a foundation supports and stabilizes a home or a skyscraper. Without a strong foundation the nose may collapse and change shape. This collapse most commonly occurs in the middle region of the nose (cartilage at the middle of the nose called the middle vault) leading to structural weakening in that region. The middle nasal vault is destabilized and the nose collapses leaving a fixed saddle nose deformity. Other symptoms include; nasal obstruction, nasal valve collapse, infection, chronic congestion, and nasal pain. If you are experiencing any of these symptoms you should be evaluated by Dr. Hamilton as soon as possible.

Q: Choosing a Surgeon. How Do I Find A Septal Perforation Specialist?

A: Why is Dr. Hamilton’s success rate so high compared to others?
Septal perforation surgery is not regularly performed by many ENTs, plastic surgeons or cosmetic surgeons. Experience with septorhinoplasty does not make one qualified to repair septal perforations. Septal perforation repair is a much more technically complex procedure to master. The only physicians truly qualified to perform septal perforation repair are those who have dedicated there practice to the management of septal perforations such as Dr. Hamilton. Dr. Hamilton’s high success rate is rooted in his dedication to managing this complex conditions. He manages approximately 5-7 cases per week operating every 4-5 days per week. His unique ability to perform septal perforation surgery via several different approaches (developed specifically at the Osborne Head & Neck Institute) instead of a one-size-fits-all approach sets him apart and has allowed him to have a near perfect treatment record for patients suffering with small and large perforations.

Patient Reviews

I’m so grateful that Dr. Hamilton took the time to speak to me when I was so lost as to what to do with my nose. Dr. Hamilton was patient, kind, well informed, and explained everything well enough to make me feel at ease. I flew from NYC not knowing what to expect but trusting that God was leading me into the right hands.

Today I sit here with splints removed, excited and relieved with my nose. What a miracle to see God use doctors like Dr. Hamilton to bring a smile to peoples faces. Thank you to everyone at Osborne Head & Neck for everything. You guys rock!!!

New York, NY

Septal Perforation Patient Guide

1. Septal Perforation Introduction


What is a septal perforation?

2. Septal Perforation Causes & Symptoms


What causes a septal perforation?

3. Diagnosis & Complications


How is a perforation diagnosed?

4. Nasal Deformity & Saddle Nose


Can the nose collapse?

5. Nasal Deformity & Cocaine Use


How can cocaine deform the nose?

6. Septal Perforation Treatment


How is a perforation treated?

Research & Publications

Dr. Hamilton is dedicated  to clinical research and outcomes evaluation for patients suffering with septal perforations. As a dedicated scientists he has over 54 book chapters and peer-reviewed journal articles published in the medical literature. Many of his research papers have focused on the diagnosis and management of otolaryngologic disease including the reconstruction of facial defects caused by head and neck surgical procedures. Dr. Hamilton continues to actively investigate and develop advanced procedures for the treatment of septal perforations.

Becoming Our Patient

Your Septal Perforation Surgery

As a patient considering septal reconstruction for a septal perforation, researching and finding the right surgeon to perform your septal perforation repair can be a very anxious and frustrating period. It is difficult to find a surgeon who regularly performs this procedure and has high success rates. Remember, most physicians rarely if ever perform surgery for septal perforations. Even less have great success rates. We believe it is always in your best interest to get a second opinion. There is no substitute for focus and experience. Dr. Hamilton has extensive experience repairing septal perforations and has a success rate of over 99% for small and large perforations. We understand that it is often inconvenient, time-consuming and expensive for patients to fly to our Los Angeles office for a consultation, and then fly back again a few weeks later for surgery. We have designed a program to facilitate your experience that will allow you to determine the best options available to you from the comfort of your home.

Contact Us Now For Your Phone Consultation

The first step is to call or e-mail our patient care consultant, and request a preliminary Phone or In-Office Consultation with Dr. Hamilton regarding your septal perforation.

Send Photos

Please provide clear, recent close-up full-face photos portrait, profile, oblique, and nasal base. Photos should clearly show the area of concern (nose) and can be sent by mail or e-mailed (preferred). This is especially important for patient who have had previous rhinoplasty and or have a cosmetic deformity.


Obtain an Evaluation

Dr. Hamilton will review your history, physical exam findings, all reports, films and photographs before your consultation. It is very important that we have all your information prior to your consultation. This is especially important in revision rhinoplasty cases associated with septal perforation. We may also ask you to send CT scan results of the septum/nose/sinuses via compact disc to our office. If you have not had a CT scan we ask that you have one completed before your consultation. If you are an out of town patient we can help facilitate you receiving a scan in your home state. If you are having difficulty obtaining your records from your prior surgeon or institution contacts us and we can facilitate and/or expedite the process for you. We will need you to sign a release of medical records to our office prior to us contacting your physician or hospital. After reviewing all your information Dr. Hamilton will then discuss all your surgical options including any adjunctive procedures. Together you will come up with a customized treatment plan. Finally, our Patient Care Consultant who will discuss pre-operative care, costs, recovery, local accommodations and any questions related to your procedure(s), will then contact you.

Patient Forms

Our patient care coordinator will provide you with the specific forms you need to fill out before your visit. For more information, please contact our patient coordinator at (323)-363-6653.

Schedule Your Procedure

Once you have decided to proceed, we will reserve your surgery date.

Read, Initial, Sign

Shortly after your surgery is scheduled, you will receive a packet in the mail containing pre-operative instructions and procedure consents. These documents must be read carefully and all instructions followed closely. All contents must be signed and initialed. The entire pre-operative packet must be brought with you to your pre-operative office visit. If you have any questions at this time, please do not hesitate to call or email the office for clarification.


Surgery Disclosure Policy

At the Osborne Head & Neck Institute, all of our board certified physicians perform all surgeries from start to finish. Although we conducted clinical research studies and contribute a significant amount to journals and publications we are not a surgical-training center. This simply means that, Dr. Hamilton, a board certified facial plastic and reconstructive surgeon, performs ever aspect of your surgery beginning to end. We do not allow residents, fellows, or other trainees to perform any portion of your surgery.

Embassy / Visa Information

For travel outside the U.S. please contact your perspective Bureau of Consular Affairs for assistance on obtaining a travel visa. Please allow ample time approximately 2-4 weeks prior to your procedure for paperwork to be processed by the U.S. State Department and your government consulate. Please call if you need assistance with this process or click the link here:

Fly in for Surgery

Our local international airport is LAX. We are located approximately 20 minutes from LAX. You MUST arrive one to two days prior to your surgery date. At a designated time during this period you will meet with the doctor(s) and have an in-depth consultation discussing all procedures. All consents should be signed and dated for the pre operative appointment. If you have any questions, please do not hesitate to call or e-mail our office. Nearby airports:

  LAX  |  Burbank  |  Ontario  |  Orange County


These hotels are located close to our office and are the most convenient for appointments, surgery, and follow-up. We have also had positive feedback about these locations from our patients.

Four Seasons | Hotel Sofitel | Beverly Terrace | Carlyle Inn | Residence Inn | Wilshire Crest Inn

Lodging Information

Travel Stipend Available*
*A travel stipend is provided to assist patients from out of town. Travel stipends assist out of town patients with ancillary costs directly associated with their surgery. Stipends may cover part or all of the cost of airfare, ground transportation, and/or lodging, and are available only to surgical patients. Travel stipends are granted by a committee on a rolling basis. Resources are limited annually. Please ask Noelia Fedi (surgical coordinator) if you would like to be considered.

*Stipends provided through a generous grant by the Division of Head and Neck Oncology (OHNI). Administered by the Osborne Head and Neck Cancer Foundation.


We advise all patients that fly-in for surgery to spend at least the first night after their procedure in a local hotel or after-care facility, thus ensuring convenience for any required medical attention. In the days that follow we will see you post-operatively and, depending upon the procedures that have been performed, you may return home within after 5-7 days after arrival in Los Angeles. In the event that you require any medical attention after returning home, we will refer you to a local physician for a check-up. Your health and safety remain our number one priority. We look forward to meeting you and assisting in your care.

Contact OHNI

Contact Osborne Head & Neck Institute

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Los Angeles | Houston | Chicago | Orlando | New York City

Osborne Head & Neck Institute

Osborne Head & Neck Institute

8631 West 3rd Street #945E

Los Angeles, CA 90048

Houston, TX

Houston, TX

Chicago, IL

Chicago, IL

Orlando, FL

Orlando, FL

New York, NY

New York, NY