Question: I had septoplasty 9 months ago, in the UK. This left a septal perforation that causes whistling specially when trying to sleep. I plan to get rhinoplasty-septoplasty (remove bump on my nose and fix perforation) BUT i also compete in kickboxing, once my nose is healed how weak will it be compared to my nose without rhinoplasty-septoplasty? can it still be durable enough for competition? I’m 19 and I don’t want to give up this sport for the rest of my life just because of a nose job.

Dr A’s Answer: After rhinoplasty, the nose is always going to be more susceptible to injury given the same trauma. In other words, the exact same hit to the face may not cause injury to a virgin nose, but may damage one that has had rhinoplasty, even though the rhinoplasty may be fully healed (1 year out or more). While you can’t predict everything that is going to happen in life, you can predict that certain activities, like boxing, will result in significant impact to the nose. You really don’t want to have additional surgery if you can help it for multiple reasons. Secondary surgery is more difficult, less likely to be effective, costs more, has a higher complication rate and requires another recovery period. So, as others have said, when you have retired from activities that will predictably result in nasal trauma, then you can proceed with your rhinoplasty. And as a side note, common post-rhinoplasty accidental injury include basketball (rebounding elbows mostly), large dog headbutts, and small children headbutts. Surprisingly, I have also seen a couple of “running into a door” injuries.