Multiple nasal piercings can be a striking form of self-expression rooted in fashion, cultural heritage, or personal identity, but they also bring unique considerations to rhinoplasty planning.
At New Face NY, rhinoplasty for pierced patients is approached with a blend of surgical artistry and technical foresight. Dr. Richard Westreich, a double board-certified facial plastic surgeon with over twenty years of specialized practice and an extensive record of peer-reviewed research, has treated many individuals with septal, nostril, and high nasal piercings. His planning process accounts for piercing placement, scar tissue patterns, and cartilage integrity, ensuring that every procedure achieves structurally sound results that remain natural-looking well into the future.
The Risks of Nasal Piercings and Rhinoplasty
Nasal piercings—especially multiple or septal ones—can introduce several factors that surgeons must account for before rhinoplasty. This means considering:
Infections, hypertrophic scars, or keloids
- Piercings pass through skin and, in some cases, cartilage
- If cartilage blood supply is disrupted, the tissue is more vulnerable to infection, delayed healing, and abnormal scar formation, such as hypertrophic scars or keloids
- Scar tissue in the nasal area can be denser and less elastic than surrounding skin, which may affect how tissues respond to surgical reshaping
- Infections, even if resolved prior to surgery, can leave behind subtle structural changes that must be considered during rhinoplasty design (NIH)
Septal hematomas or perforations
- Piercing the septum incorrectly or with inadequate aftercare can damage the delicate septal lining and underlying cartilage
- This may lead to a septal hematoma (a buildup of blood between cartilage and its lining) or, in more severe cases, a septal perforation (a hole in the septum)
- Both conditions can weaken nasal structure, alter airflow, and limit the availability of healthy cartilage for grafting—an essential tool in many rhinoplasties
Interference With surgical landmarks or nasal support
- Every rhinoplasty relies on clear anatomical landmarks to achieve precise proportions and symmetry
- Piercings that have altered skin elasticity, created uneven scar tissue, or weakened underlying cartilage can shift these landmarks
- This can make surgical measurements more complex and require specialized techniques—such as Dr. Westreich’s Foundation Rhinoplasty™—to rebuild or reinforce nasal support while achieving the desired cosmetic outcome
Preoperative Considerations
- Remove all piercings securely before surgery because loose jewelry increases the risk of catching on surgical drapes or causing injury
- Allow closure of piercing tracts prior to operating, especially if they lie in areas affected by planned incisions or graft placements
- Assess skin and cartilage health, as multiple piercings may weaken tissues or obscure subtle anatomical landmarks
- Discuss which piercings can and cannot be kept open after the surgery. Some piercings may have to be redone at a future time
Timing & Postoperative Guidelines
- Refrain from re-piercing for at least 8–12 weeks post-surgery, or longer, depending on individual healing
- Early piercing increases the risks of infection, delayed healing, or alteration of surgical results
- Selecting timing should be personalized—complete tissue healing, scar maturation, and stabilization of structural changes should guide readiness
Surgical Strategy at New Face NY
Our approach to rhinoplasty for patients with multiple nasal piercings is both meticulous and highly individualized, including:
- A comprehensive clinical history review: We document all piercing sites, how long they’ve been in place, any history of infection, allergic reactions to metals, and healing outcomes (including scar formation or skin discoloration). This history helps us anticipate tissue behavior during and after surgery.
- Detailed skin and cartilage evaluation: We examine for scar tissue, cartilage irregularities, or areas of reduced vascularity that may alter incision placement or require additional grafting support.
- Adaptive incision planning: Incisions may be shifted, reshaped, or minimized to avoid crossing old piercing tracts, which could otherwise reopen, weaken skin, or cause irregular scar patterns.
- Structural reinforcement techniques: We use cartilage grafts or suturing methods to restore strength in areas weakened by piercings, ensuring that nasal support remains stable for the long term.
Preserving Identity While Refining Proportion
Multiple nasal piercings don’t preclude beautiful rhinoplasty outcomes, but they do require proactive planning. When healing is respected and technique is tailored, piercing and plastic surgery can coexist with elegance. Contact us today to schedule your private consultation at New Face NY.
