How to Fix a Crooked Nasal Cartilaginous Bridge?

Crooked noses are fixed many ways. Select an experienced rhinoplasty surgeon whose results look natural.

Straightening a crooked dorsum can be one of the most challenging problems in nasal surgery.  One of the reasons the bridge can be crooked is due to a deviation in the cartilaginous portion of the dorsum, which is the equivalent position of the upper lateral cartilages and dorsal septum.  To address a crooked nasal cartilaginous bridge, changes must be made to these structures.  If the patient has long nasal bones and a short middle vault, osteotomies to the nasal bones may correct a deviated cartilaginous bridge. However, spreader grafts typically are required to address a depressed upper lateral cartilage. Other techniques which may be required include placement of a onlay graft. As you can tell, several techniques can be used to correct the middle dorsal vault, however the surgeon should choose the appropriate technique based on each individuals anatomy.

Fixing a crooked nose can be very challenging and can occasionally be accomplished with strategic incisions and sutures whereas more complex problems may require cartilage grafts to establish, hold or secure the desired structure.

Hello,

I would really need to see photos in order to provide you with any advice, as every individual has different circumstances. Please feel free to send any photos to my office and I would be happy to evaluate them for you. My contact information is listed in my profile. Thank you for the question, and good luck.

Hi veronica sawyer in Wallingford, CT,

Rhinoplasty is not one operation, but many potential operations. Every patient is unique. The primary goal of cosmetic rhinoplasty surgery is to reduce attention from the nose, and bring attention to other parts of the face such as the eyes and lips.

Facial or nasal symmetry is common, and essentially normal. No one has a perfectly symmetric face or nose. Rhinoplasty may improve asymmetry by reshaping cartilage, bone, or skin. The bridge of the nose, or the upper 1/3 of the nose, is made of bone so osteotomies or rasping may be required to help straighten the nose.

Speak with a plastic surgeon to perform a comprehensive evaluation and to help determine appropriate options for you.

Typically, crooked cartilage in the nose relates to a deviated septum. This may be a traumatic or developmental occurrance, likely the latter.

Extended septoplasty techniques, with or without limited grafting and/or nasal bone correction is typically required to correct this problem.

Make sure to see a Septorhinoplasty specialist who has extensive experience with both Rhinoplasty and Septoplasty procedures for this problem.

All the best

Hi Veronica,

Rather than "how to fix a crooked nose?", you should find an experienced and skilled rhinoplasty surgeon.  Your surgeon will have know the techniques to help you achieve your nasal aesthetic goals.  Choose your surgeon most carefully.  Good luck and be well.

Dr. P

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. 

Anytime the nose is crooked there is a long side and a short side associated with the nasal bones and cartilages. It is important to have your surgeon look at the inside of the nose, which is most likely crooked as well. This needs to be addressed at the same time and is considered a septoplasty. Straightening the nasal pyramid will require both medial and lateral osteotomies to reset the nasal bones. With respect to the upper lateral cartilages in the mid-third of the nose, the twisted and concave side will probably require a spreader graft composed of the patient’s own cartilage from the septum to bolster that upper lateral cartilage on that depressed side. This is all done through closed rhinoplasty techniques and is an outpatient procedure and usually performed under general anesthesia.  

What you are describing is usually due to a deviated nasal septum and possibly an accompanying nasal bone deviation. Septal deviation of the portion of the septum that makes up the lower bridge of the nose may require more than a simple septoplasty. Sometimes the septum needs to be separated from the the other cartilages making up the lower bridge of the nose and occasionally grafts of cartilage are necessary to stabilize the septum and to reduce its tendency to 'bow'. It is important to have a thorough exam of course and ask your surgeon to tell you in clear terms just what is causing the the look you are seeing. Although a certain amount of asymmetry is the norm, significant deviation off-midline can usually be addressed and improved. Best of Luck