I have a long nose, that appears to me too big for my features, and appears to be deviated to the right (after a trauma in my childhood). In addition, I have a strange profile that I have never seen on nobody, with a really too straight line between forehead and the nose, that make my nose appears too long. Am I a candidate for a rhinoplasty? Or the deviation is too little? And the profile can be changed? thank you for your advice
What Kind of Procedure Would Be the Best to Correct a Too Straight Profile and Deviated Septum? (photo)
Doctor Answers (7)
Procedures to address deviated septum and nose profile
A septoplasty is performed to improve airflow dynamics through the nose and correct a deviated septum. This is typically billed to the patient’s insurance while elective cosmetic surgery procedure is billed directly to the patient. A twisted nose profile is addressed through osteotomies to straighten the nasal bones and a spreader graft on the concaved side to realign the midthird of the nose. A spreader graft is a piece of the patient’s own cartilage harvested from the septum to improve the crookedness of the midthird nasal vault. Any bridge line improvements can be made at the time of the rhinoplasty if the patient wishes to do so.
Your posted photos show deviated nasal bones (upper 1/2 of the bridge) and septum (cartilage lower 1/2 of the bridge). I suspect it is a C-shaped deviation concave to your left. If you have a medical record documented history of trauma to the nose and/or obstruction to airflow in the nose surgery to straighten the nose may be covered by your health insurance. California state law has an extended definition for reconstruction that would make insurance carriers here cover surgery to straighten your nose. Correcting the bone position will require osteotomies. It's unlikley you would need to rasp or camouflage graft the bone. The septum would require your standard septoplasty with removal of a window of cartilage in the center of the septum to allow it to straighten. It is hard to tell from the photos but the root of the nose on side view appears to lie below the level of the upper eyelid crease. That can be raised to a more aesthetic height with a cartilage graft to the root area (radix).
I am not so sure the nose is too long but trimming the upper edges of the tip cartilage can rotate the tip up a few degrees making it appear to be a bit shorter.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Procedure to Correct Deviated Nose
A septorhinoplasty is the procedure that would be done to correct your deviated nose because it is more than just your septum that is crooked. Your picture is not clear, but consider refinement of your tip. Many people would love to have your straight profile, but alternatives to change that should be discussed during your consultation.
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Rhinoplasty for a crooked nose
You are a candidate to have features of your nose improved with rhinoplasty. A better question to ask is what features are you trying to improve?
The bridge of your nose is deviated to the right and can be straightened with surgery. This would achieve an elegant line curving naturally from the eyebrow to the tip of the nose. Anything else accomplished with rhinoplasty I would recommend to be relatively minor.
With regards to your specific concerns: your nose is not too long. It is very well proportioned to the middle third of your face and enhances the natural angularity of your cheeks. If you were to shorten your nose, your upper lip would appear proportionately longer.
The bridge of your nose is almost perfect on profile view. The options would be to either very slightly reduce the bridge of your nose or build up the top of your nose to make the line straighter. I would favor building up the radix (the part of your nose between your eyes). Anything that reduces the size of your nose will make your chin proportionately larger. At the moment I would suggest that your nose-to-lips-to-chin ratio to be very aesthetic and I would be reluctant to significantly alter it.
Hope this helps.
Procedure for deviated nose
Your nose is definitely deviated and you certainly could have it straightened with a septorhinoplasty if it bothers you. Your profile is very straight and actually many patients desire this look as a rhinoplasty result. I would suggest you have some computer imaging to see what changes would look like. It would not favor you to be "scooped". Also keep in mind that your face (like everyone's) is not symmetric and when you straighten your nose it will make you look different.
Rhinoplasty for straight nose
You have a beautiful face with nice angles and features. As you age your tip will fall a little. I would hesitate to recommend any surgery since you have a unique appearance that is very attractive. Be VERY careful if you find a surgeon who is eager to accommodate you.
Correction of a crooked nose
It appears that your nose is deviated to the right side and you have a rather straight nasal profile. These are two features of your nose that can be corrected. A septoplasty would be necessary to straighten your nose. A trimming of the cartilage of the nasal dorsum would help to break up the straight line of your nasal profile. You are correct in observing that your nose is very straight on profile. This gives it a long appearance even though it does not appear that your nose is long. A relatively simple modification of the dorsum to give you a supratip break point would help break up this straight line. This break point would differentiate where the nasal tip ends and the dorsum begins.