What is the best approach for correcting caudal septal deviation with a tip which is asymmetric due to the deviation? (Photo)

The approach I recommend is doing an open rhinoplasty/septoplasty.

Best Wishes,

Gary Horndeski, M.D.

There is an old expression that says "where the septum goes so goes the nose." Additionally, in our experience, if the bottom of the nasal septum is off of the midline into one side of the nose, it can cause the Columella and tip to veer in the opposite direction. Septoplasty is commonly performed along with rhinoplasty surgery to achieve a straighter nasal appearance and to improve someone's nasal Airway. Attached video demonstrates a similar situation. I hope this helps! Sincerely, Dr Joseph

Hello, hope you are well. It can be addressed through an endonasal (transfixion incision) or an open rhinoplasty approach depending on the severity of the issues and the 3-dimensional appearance of the nose. If there are significant external nasal asymmetries, my personal bias is to perform an open septorhinoplasty approach because it offers the greatest access to reconstruct the septum and stabilize the tip.
Best,Dr. Tower

Correcting caudal septal deviation: There are several ways to address caudal septal deviation. The goal is to place the caudal septum in the midline. This can be done with a procedure called a septoplasty. There are several technical choices. Some may involve removing a portion of the septum and moving the caudal portion and suturing it to the midline. Some may involve a combination of scoring the concave surface of the septum to reduce its curvature along with repositioning the caudal septum in the midline. In some cases a Cartilage Graft may be applied to the crooked septum to help straighten it. In some cases a caudal septal extension graft may be employed to help place the caudal most portion of the septum in the midline. Having the caudal septum in the midline is important not only for the airway, but for the appearance of the tip and also the appearance of the rest of the nose which could look quite crooked after rhinoplasty if the caudal septum is not in the midline.