Can your nose change shape from cocaine use?

Yes: Cocaine use can result in death of of tissue (septal necrosis) with consequent undesirable change in nasal appearance. Some mechanisms might include reduced blood flow and/or unchecked infection. Cocaine use is associated with a variety of undesirable general medical and psychological adverse effects.

Possibly: Nasal septum (the inside part between your nasal passages) can be damaged by snorting cocaine, and can develop perforations. If the damage is severe enough, the septum might collapse and the nose could change shape.