When I was 18 I had an industrial done. Then at 19, septum piercing and a conch dermal punch. I stretched the septum to 6mm. Haven't worn anything in any of my piercing holes for years, at least 5 or 6 years. At this point, my industrial has totally closed up, both holes. I have little scars there but it's not noticeable. My conch is just as open as it always has been, because I had a chunk of ear cartilage cookie-cutter punched out of my ear. I don't wear anything in it. It's 3mm. Just looks like a mole or something, at least that's what most people say when they find out it's a hole, or when they see light shining through my ear.
My septum, which I stretched so large that it dented my cartilage (SUPER painful because of how sensitive that area is), has shrank to about 3.5mm (don't ask me how I know that... lol). I used to be able to stick my glasses leg through it to freak people out. It didn't deform my nose, btw. It still looks like it always has.
I really liked glass jewelry, which looks cooler the larger it is, thus the septum stretching.
I kind of want to put jewelry back in my conch and get a really tiny, small diameter captive-ball-ring for my septum, one that almost hugs the skin.