Can a Crooked Nose Be Repositioned Without Breaking It?

The only time that crooked noses can be straightened without osteotomies is when the deviation is confined to the lower cartilaginous 2/3 of the nose. In that circumstance, septoplasty with camouflage grafting (foundation rhinoplasty) can often straighten the nose almost completely.

If your deviation truly arose from trauma, then your bones probably were broken and need to be reset. If somehow you only fractured the septum, then bone breaks may be avoidable.

Best of luck and hope this helps.

In all likelihood a crooked nose cannot be repositioned without breaking it. A non-surgical rhinoplasty may provide you with some temporary improvement.

First, the explanation Dr. Aldea puts forth is simply incorrect. Most---nearly ALL--septal deviations are NOT from trauma, but are developmental and follow the fusion planes of the septal cartilage with the four bones of the septum. These deviations tend to develop as the person grows into their adult face. Severe enough septal deviations can create external deviations of the nose, too.

Certainly there are cases where trauma causes a crooked nose and septum, but these are IMMEDIATE, not delayed in their presentation. So if the nose was straight after your injury and LATER became crooked, it is nearly impossible that it was secondary to that trauma.

The distinction, however, is largely moot. If the crooked part of the nose is purely of the cartilage, no osteotomies (bone cuts) are typically required. OTOH, a bony deviation WILL require osteotomies for proper correction.

Note that osteotomies are not really the same thing as breaking the nose since the latter implies a violent, painful, and imprecise maneuver. That is simply not how it's done. It's like the difference between smashing a piece of sculpture versus carving one.

Don't fear the osteotomies. :-)

All the best,

--DCP

A crooked nose from trauma is typically due to broken nasal bones or a nasal fracture with or without cartilage that has been mishapen or shifted.  The septum (the wall that separates the two sides of the nose) may also be deviated after trauma.  Typically, a crooked nose requires the bones to be rebroken after the initial injury.  This is done in a controlled fashion with what are called osteotomies.  This will help move the bones back into position and provide for a straighter nose.  Cartilage and/or septal work may also be necessary.

It is impossible to straighten the nose without re-breaking it. Both medial and lateral osteotomies must be performed to realign the crooked nasal bones. Often times we have to put a spreader graft of cartilage on the inward ways deflected side to allow the cartilaginous mid third of the nose to be even with the nasal bones. This will have to be addressed by your rhinoplasty surgeon at the time of consultation.

Rhinoplasty is not one operation, but rather many potential procedures. Patients who have had a broken nose usually may require osteotomy or bone reshaping to realign the deviated nose. Rhinoplasty to reposition nasal bones or cartilage generally require a break somewhere to achieve appropriate results. One can consider rhinoplasty as a controlled break in the nose. Speak with a plastic surgeon to help determine appropriate nasal surgery operations for you, which may also include septoplasty for a deviated septum.

Usually no, but without photos impossible to answer accurately. Dr. Adles again has given a good starting point. Seek 3 opinions from boarded surgeons in your area.

From MIAMI Dr. B

Most  nose fractures are undiagnosed. People just do not bother to have them addressed or follow up on them. As a result, we see a lot of people with septal deviations and evidence of old fractures who give us histories of sports injuries. 

Logically speaking, if it were not for a pretty good injury, why would a fairly straight nose suddenly begin turning to the side?  

In straightening the septum, curved areas are either straightened or removed and the straight septum is swung back to the center. However since the original injury had narrowed the airway on the side of the blow, the vast majority of Septoplasties (correction of the septum) involve breaking the sides of the nose to allow the relocation of the nasal bones to a central location.

Although it is occasionally possible to successfully correct a crooked nose without breaking it, this is rare. Submit photographs to help us evaluate your particular problem and make more specific recommendations.