Options for Progressively Crooked Nose?

My nose used to be perfectly staight and over the years it is getting progressively more crooked. My ENT says that I have a deviated septum and that I probably had it, but if you compare pictures from 10 years ago to now, there is a big difference. Any ideas?

Doctor Answers 15

Correcting the crooked nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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.

Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Rhinoplasty Will Help Crooked Nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

                  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. 

Options for correcting a progressively crooked nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
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.  Straightening the outside portion of the nose will require osteotomies to narrow and straighten the nasal bones, potentially spreader grafts in the upper third of the nose with 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

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

As the septum goes so goes the nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Another question to ask is " Do you have any difficulty breathing through one side of your nose?" As the other replies have indicated a deviated nasal septum can affect the outer appearance of the nose over time.

I often will combine septoplasty (if needed) with cosmetic rhinoplasty to help a person achieve a look that they desire. So they will be able to breathe well through their nose and be pleased with the external appearance.

Good Luck!


Robert F. Gray, MD, FACS

Robert F. Gray, MD, FACS
Bay Area Facial Plastic Surgeon

Progressively crooked nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes, you do appear to have a septal deviation. Our noses do change over time as the soft tissue and fat diminishes, and deviations in the cartilage therefore become more apparent. In addition, the tip of the nose tends to droop with age as well. I would recommend seeing a surgeon experienced in rhinoplasty for an evaluation and surgery if desired. Good luck, /nsn.

Progressively Crooked Nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Noses do change with time, just like other parts of our body. Go to a retirement home and look at the residents; they did not have those noses all of their lives. However, the deviation may have been present all of your life, but is now visible because of changes in the skin and subcutaneous tissue. Correct the deviated septum and enjoy your improved breathing.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Progressively crooked nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}


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

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Nasal deviation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 Nasal deviations are the rule as opposed to the exception.  You may not have noticed it when you were younger, or as one person suggesting, the soft tissues just got a bit thinner and the deviation is more noticeable.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Crooked nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
As you age, things give way to gravity...that includes your nose. The cartilage and skin in and on your nose is losing elasticity. Loss of elasticity is due to disruption and weakening of the collagen in the dermis of your skin and cartilage of your nose. This in turn will affect the shape of your nose and may the ability to breathe through one or both of your nostrils.
In my opinion, to correct this, you should have an open rhinoplasty to straight the bridge (dorsum) of your nose. This may involve placement of spreader grafts ( cartilage grafts to used to straighten the dorsum and re-support the nasal valve). Also the tip of your nose should be re-supported with cartilage grafts so that the tip doesn't droop with time and will also help your breathing. Lastly, of course, correction of your internal deviated septum.
There is example of this in the picture section of by profile.
I hope this helps. Best of Luck.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Can a nose become crooked with age?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

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!

Ran Y. Rubinstein, MD
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 158 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.