A collapsed nose due to long-term, heavy cocaine use. The cocaine breaks down the soft tissue, cartilage, and the bone as well. Patients with this problem have a nose that is flattened, does not breathe well, bleeds often, and has tremendous crusting. Sometimes the erosion can even include the roof of the mouth (palate). Nasal reconstruction requires complex grafting and usually required rib cartilage graft with total reconstruction of the L-strut.