It is possible to leave the deviated septum alone. The dorsal hump and poly-beak can be addressed by shaving down the bridge line. A spreader graft will also need to be performed underneath the concave upper lateral cartilage area. For many examples, please see link below
Revision rhinoplasty is done to correct the deformities after the primary rhinoplasty and therefore, all of the problems are usually addressed. The septal deviation which often leads to nasal deviation, as well as poly beak deformity can easily be corrected by any experience surgeon.
A closed rhinoplasty can be used to reduce the pollybeak, straighten the nose, and
refine and lift the tip.
Find a board certified plastic surgeon who performs hundreds
of rhinoplasties and rhinoplasty revisions each year. Then look at the
plastic surgeon's website before and after photo galleries to get a
sense of who can deliver the results.
Kenneth Hughes, MD
Los Angeles, CA
Hi Sheldon: Revision rhinoplasty can be difficult but I do think an experienced rhinoplasty surgeon could make a significant improvement. Cartilage grafts can be used to straighten a crooked septum. Likely, simply removing a bit more of the dorsal septum will straighten your profile and remove the hump. Tip cartilage sutures and possibly a small cartilage and/or fascia graft for camouflage will make your tip more symmetric. Best of luck.
Hi. You definitely will need the septum addressed to ensure a straight nose - the septum is the cause of the deviation. The tip could be elevated and dorsum straightened at the same time, with the use of spreader grafts being necessary. Regards Dr Charles Cope
Based on the pictures posted, all your concerns can be corrected with a septorhinoplasty. Straighten the nose, with spreader grafts, elevate the tip and correct the dorsum.
Samir Shureih MD. FACS
Contrary to what you've read, your septum and deviation of the nose can be corrected. A revision is indeed a bit more complex, but see a surgeon who performs and is confident in their abilities with revision rhinoplasty. Cartilage grafting will be necessary to straighten out the nose. I predict that you will be happy with the outcome.
A crooked septum always wants to stay crooked, but there are several maneuvers including using grafts to try to straighten it. The tip certainly can be lifted, and the pollybeak most likely related to inadequate resection of dorsal septum can be treated.