A crooked nose can present a host of problems, including trouble breathing and aesthetic issues.
Unfortunately, crooked noses are a fairly common problem that compel prospective patients to seek rhinoplasty. While rhinoplasty surgeons are used to seeing this problem on a regular basis, they are one of the more difficult problems to treat with an already difficult procedure. That said, significant improvement can be made to the functionality and aesthetics of a crooked nose through surgery with a skilled facial plastic surgeon. There are several causes of a crooked nose, and it is helpful to understand the nature of your own nasal crookedness if you are planning to move forward with surgical correction.
Causes of Crookedness
One of the most common causes of a crooked nose is the deviated septum. The septum is the wall separating the two nasal passages, and while many people have a slight deviation, more serious deviation can result in breathing problems and nasal crookedness. This is an issue that is typically present from birth, but can also be caused by significant injury to the nose.
Broken noses often do not heal properly, and nasal trauma is a leading cause of nasal crookedness. Because of its positioning on the face, the nose is prone to injury from many different sources, and nasal trauma is unfortunately quite common. Since rhinoplasty cannot be performed until the nose is mature, children who experience nasal trauma often have to wait to get corrective surgery long after the injury.
Sometimes, genetics or the birth process can result in nasal crookedness that will not resolve on its own. It is not always clear as to the source of the issue, but it does occur from time to time.
Diseases affecting the connective tissue of the nose or autoimmune disorders can lead to nasal degradation, which can, in turn, lead to nasal crookedness. There are many conditions that can affect the nose, and rhinoplasty can offer relief in some cases.
Unfortunately, not all rhinoplasty procedures have an ideal outcome. Sometimes, the structural integrity of the nose is compromised during the procedure, which can later on cause problems contributing to a crooked nose. Poor healing can also have an impact on the problem. Many of these problems can be avoided by choosing the right surgeon and practicing diligent aftercare.
Techniques for Crooked Nose Rhinoplasty
Obviously, techniques vary greatly from case to case, depending on the nature of the nose’s crookedness and a myriad other factors. There are some techniques that are regularly used in rhinoplasty to straighten the nose, however, including:
Because the deviated septum is a common reason for patients to seek rhinoplasty, septoplasty (surgery of the septum) is often called for. The septum is straightened to allow for proper airflow and aesthetics. The amount that the septum can be straightened has to do with the amount of deviation.
In some cases, particularly when the nasal bones have healed poorly from a prior break, it is necessary for the surgeon to surgically break or cut the bones to allow for proper healing and re-setting of the bones. While this concept is unsettling to many patients, it is a common and reliable method that has been used by surgeons for centuries.
Cartilage grafting is used in nearly every modern rhinoplasty procedure performed, and surgery for a crooked nose is no exception. Cartilage is taken from the nasal septum, the ear, or the rib to reinforce the nose’s structure or change the shape of the nose beneath the skin. Spreader grafts are especially common during this type of procedure.
Because rhinoplasty is such a difficult surgery and healing is a major variable in the eventual outcome of the procedure, it is important for patients to be realistic about the potential results from rhinoplasty. Even with the most skilled surgeon, it is not possible to achieve perfection, and patients should go into the procedure aiming for improvement, rather than perfection. Naturally, the results depend on the severity of the crookedness, the patient’s nasal features, the surgeon’s skill, and proper pre and post-operative care. Digital imaging can produce good estimates of final results, but patients need to have an open mind and keep their expectations in check, as the final outcome will not match the preview.
Selecting a Specialist
If you are selecting a surgeon to perform rhinoplasty for a crooked nose, then you will need to be extremely cautious. Rhinoplasty is one of the most difficult plastic surgery procedures to perform, and only the most dedicated of specialists have the skill and experience to assist patients with a crooked nose.
The first qualification you should look for is board certification. This indicates a superior level of training, testing, and experience. Your surgeon should also be a dedicated facial plastic surgeon who puts an emphasis on rhinoplasty, with evidence of great results to back up his or her work. Rhinoplasty requires an artistic eye and a skilled hand, and you should do as much research as possible before scheduling your consultations.
Dr. Stuart Bentkover is a board certified plastic surgeon who enjoys helping patients reach their cosmetic goals with a wide range of facial procedures, with a special emphasis on rhinoplasty. Dr. Bentkover has been honing his rhinoplasty skills for over two decades, and specializes in the procedure. If you would like to learn more and schedule a consultation with Dr. Bentkover, call Bentkover Facial Plastic Surgery in Worcester(508-363-6500) or Stoneham(617-247-0033), MA.