Options for Progressively Crooked Nose?

The crooked nose can result from a deviated septum and may get progressively worse as one ages. In addition, incidental trauma or sports related trauma or just bumping your nose hard enough can cause further progression of the crooked nose over time. Furthermore, as we age the tissues weaken and an inherently bent septum can result in further deviation of the nose over time much like a bridge which begins to weaken and collapse due to use and stress. The good news is that surgery can be done to straighten the bend and strengthen the underlying structure so that further bending over time can be avoided. My only advice there is to see a facial plastic surgeon who is both experienced in internal and external nasal surgery since correcting a crooked nose is a more difficult nose surgery or rhinoplasty than performing a nose surgery on someone to improve the appearance in a person with a straight nose. I hope this information helps.

                  Based
on your history I suspect that you’ve had nasal trauma at some point in your
life. At the time of the injury, it may have seemed trivial, but was probably
more significant then realized.

                  It’s
not unusual for the nasal cartilage to slowly curve after a nasal injury. With
the passage of time the cartilage slowly starts to bend and results in a curved
nasal septum and nasal dorsum.

                  When
this situation arises the nose should be critically evaluated. Not only should
nasal aesthetics be evaluated but attention should be given to the nasal airway
as well.

                  When
a patient has a crooked nose following nasal trauma the nasal septum and nasal
bones are usually both involved. Correction of this problem usually requires a
rhinoplasty. If nasal airway obstruction is present, a
septoplasty may be necessary as well.

                  It
would be appropriate to consult a board certified plastic surgeon with
rhinoplasty experience. This surgeon should be able to formulate a treatment
plan for your problem. 

Hello,
With time, a nose may appear longer since it can droop. This is known as "nasal ptosis." Also, the nose may become more twisted due to a deviated septum. Hope this helps answer your question.
Dr. Nassif

There are a number of causes for a nose to become crooked with time.
The most common cause is from prior rhinoplasty surgery. Certain surgically techniques tend to weaken the nose and allow for scar tissue to pull the nose in one direction. In viewing your photos, it appears as if you have had prior surgery.
Breaking ones nose also can result in a deviation of the nose. This tends to be immediate and not a progressively worsening problem. Yes, it can become worse with age but most of the deviation is immediate.
There are some individuals whose nose truly begins to appear irregular or crooked with age. This is due to loss of fat and soft tissue lining of the nose unmasking underlying asymmetries and deviations which were camouflaged by the thicker covering we have in youth. Loss of bone in the face also decreases nasal tip support which can contribute to this effect.
Regardless of the cause of your crooked nose, the problem can be corrected by rhinoplasty with Septoplasty. I recommend you find someone who has a lot of experience in revision rhinoplasty.
Good luck!

The photo you posted shows a slight concavity on the left side of your nose. If you're otherwise happy with your nose, and just want it straighter, consider consulting a specialist experienced using Injectable Fillers in the nose. This can be quite gratifying, and there is no downtime.
I've attached a link to my Non-Surgical Rhinoplasty photos for your perusal.
I hope this was helpful for you.
Best regards.

 When we are young we have a great deal of fat in our face and nose. This often hides an underlying deviation which only shows up as we age. See an experienced rhinoplasty surgeon and you should have airway improvement as well as a straighter nose.

Hi Kipman,
Was your nose "perfectly straight" after having had rhinoplasty many years ago? Sometimes a "straight" result will appear crooked as a few years go by as scar contracture occurs, especially if enough structural support was not left in the nose.
If you have never had nasal surgery, then your crookedness is related to your nasal septum. Best to consult with an experienced rhinoplasty surgeon for an examination and diagnosis.
Good luck and be well.
Dr. P

From the photo you have attached, I do agree that it appears you have a deviated septum. An internal nasal exam with a speculum is most helpful to evaluate further, but it's clear externally that it has some deviation already. As we transition into adulthood, even if we are done with growing in height, sometimes the septum grows a bit more and changes a bit its shape, and it's pretty common to have a deviated septum. As the soft tissue over your nose changes in adulthood, and you lose some of the fat on your nose itself, the deviations and underlying structures can sometimes become more evident also, so even if the septum has not changed much internally it may appear that it has externally. I recommend that you meet with a surgeon to discuss your options. If you are having difficulty breathing through one side a septoplasty may help with breathing and is covered by insurance, and it would also straighten your septum a lot.
-Dr. David Mattos, New York Plastic Surgical Group

Rhinoplasty is an effective and reliable way to correct the deviation or crookedness of your nose.  The extent of surgery will depend on the severity of the deviation.  
The nose is made of bone, and cartilage.  Sometimes it is one or the other that is causing the crookedness, but usually it is a combination of all of these structures.  In rhinoplasty surgery, the nasal bones are precisely manipulated to make them straight again.  With regard to the cartilage, there are several techniques used to straighten a deviated septum which acts as a pillar and a support structure in the middle of your nose.  If this structure is crooked, it can, and often does make the rest of the nose crooked.  Straightening a septum and keeping it straight in the long term is challenging because this cartilage has "memory" meaning that if you straighten it in surgery, it will have a tendency to go back to the way it was.  This is similar to the curled pages of a book, or a magazine.  Even when you uncurl them, or straighten them, they have a tendency to curl again.  
Nevertheless, there are techniques available to straighten the septum and nasal cartilages, and maintain this straightness in the long term.  I would recommend that you seek a plastic surgeon with a particular specialization in rhinoplasty and discuss your goals and available options. 

Certainly, the cartilage and the bone may have been injured at some point and is continuing to grow crooked. A deviated septum can be fixed by itself or at the same time as a rhinoplasty if the patient so desires. A septoplasty and a rhinoplasty are 2 completely separate operations, but both can be performed at the same time under one anesthesia with one recovery period.  Straightening the outside portion of the nose will require osteotomies to narrow and straighten the nasal bones, potentially spreader grafts  placed under the upper lateral cartilages inserted onto the septum, and potentially some tip surgery to correct any asymmetries there. The internal portion of the nose may require a septoplasty and/or turbinate reduction to improve airflow dynamics through the nose. For more information, diagrams and our before and after photo gallery, please see the link below