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What Would You Suggest to Fix my Crooked Nose? (photo)

Hi, It's getting down to crunch time as I want to get my nose fixed winter break. Here's some background and what outcomes I would like. My nose has been broken twice, both about three years ago, and it is now hard to breath. Overall, I would like a straight nose, narrower, tip projection reduced slightly and nostril reduction. What approach would work best, i.e. opened or closed rhinoplasty? Would you suggest weir excisions, or are there any other kind that could reduce nostril size better?

Doctor Answers (10)

Broken nose

+1

Your posted photos do not allow for a complete analyis of the situation but do show a C-shaped bridge deviation concave to the left. The usual treatment is to remove a window of cartilage from the center of the cartilaginous septum to allow it to straighten, filing down or rasping any protruding spicules of bone, osteotomies to realign the bones and cartilage grafts to cover any residual indents or concave areas. There are pros and cons to open vs. closed approaches and the information in your post does not allow full disclosure of all the pros and cons.

It sounds like your surgery would be covered by health insurance so make sure you have the appropriate medical record documentation so the procedure can be preauthrorized by your insurance. If you have emergency room records such as x-ray reports related to the fractures that will help.

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.


Los Angeles Plastic Surgeon

Rhinoplasty for Crooked Nose

+1

In my hands I definitely commend an open rhinoplasty which I prefer in noses with severe deviations, particularly after trauma, and noses that need a lot of tip work. It is difficult to determine with the picture you submitted, but I think weirs would be beneficial.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

What Would You Suggest to Fix my Crooked Nose? (photo)

+1

Thanks for the photos. You have a very complex nose deformity. I might opt for open rhinoplasty. But ONLY in person examination will allow any expert to be certain of the operation to propose. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

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Complex nasal problems and rhinoplasty

+1

you have a challenging nose problem..  a septo rhinoplasty with open technique is probbly the best way to get your best result.  you will likely have some imperfections. but the nose should be straighter,  tip smaller breathing better

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
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What Would You Suggest to Fix my Crooked Nose?

+1

I suggest you look for an experience surgeon who has performed a number of rhinoplasties on crooked noses and have pictures to show you. There are a number of procedures that should be used in order to straighten your nose and keep it that way long term. Weir reduction is associated with scar and reduces flaring but not wide nasal base. The Alar Repositioning Technique does not cause scars and is the technique of choice both for flarring and wide nasal base.

Mohsen Tavoussi, MD, DO
Huntington Beach Facial Plastic Surgeon
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Rhinoplasty

+1

Rhinoplasty sounds like a reasonable procedure for you based upon yoru concerns.  The nose could be straighter, the tip more refined as well. A full exam is esential to plan your surgery and this has to be done in person with your surgeon.  Good luck.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Open or closed rhinoplasty for the crooked nose.

+1

About 35 years ago there were 4 of us who did open rhinoplasty and lectured about it. Today there are many surgeons who use this to excess. I would do your nose open since you will need grafting for the depressions as well as straightening and refining the tip. I feel suturing the grafts in place is one of many advantages of the open approach for your nose. See an experienced rhinoplasty surgeon who does natural noses for the best result.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

What Would You Suggest to Fix my Crooked Nose?

+1

 I have performed Rhinoplasty for over 20 years and from the photos, you have a C-shaped nasal deformity from the previous nasal trauama.  A profile view would be helpful for further evaluation as it would show the degree of nasal tip rotation.  This is one of the determing factors, for me, in choosing a closed or open Rhinoplasty as the mere fact of opening the nasal tip area causes ~ 5 to 7 degrees of upward tip rotation.  Since the aesthetically correct tip rotation is between 105 and 115 degrees for a female....this is an important issue to assess pre Rhinoplasty.

 Whether open or closed, the nasal bones need to be broken, dorsal hump removed (again profile view will help determine) and the nasal tip thinned and refined.  If the nasal septum is deviated, from the nasal trauma, a Septoplasty would be required.

IMHO, I do not like, or use, spreader grafts in the nose during Rhinoplasty as these tend to increase the size of the nasal tip and supra-tip areas because the cartilage grafts add volume to those areas. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Rhinoplasty for a crooked fractured nose

+1

Your nose has taken a beating like one involved with roller derby, or kick boxing. The repair will involve the septum and support of the depressed area on the bridge. Of course, you may have reduction and shaping of the tip as well, and the Weir pattern will depend on just how the nostril flares. Open or closed? Both work with a skilled surgeon. If closed will work, all the better.

Best of luck,

peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

What Would You Suggest to Fix my Crooked Nose?

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There are several factors contributing to your crooked nose. The right nasal bone is protruding, the left upper lateral cartiage, or left sidewall of your nose, is collapsed. Through an open rhinoplasty approach osteotomies would align the bones, and a left spreader graft would re-support the left nasal wall. Chances are your septum will be deviated as well from your previous nasal fractures. A septoplasty would address this problem.

As for the tip, you have a bulbous, or round tip, conservative trimming of the cartilage and grafting of the side walls would address the roundness of the tip.

Best of luck

 

Dr Siegel

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.5 out of 5 stars 78 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.