Can a naturally crooked nose be straightened? (Photo)

Could revision rhinoplasty straighten my deviated nose? If cartiledge grafts are used how likely is it my nose could return to being deviated again?

Doctor Answers 4

Straightening a nose can be more successful if other changes are made at the same time.

It's true that straightening the frontal view of a nose is one of the more difficult tasks in revision rhinoplasty, especially if the nose is "naturally" crooked. It does appear that you have some other facial asymmetries that would make it harder to straighten the nose successfully.

Here's what I meant by "other changes." What I notice about your nose is that it is still long, with the tip drooping down. See the "Web reference" link, just below my response. I made a couple of computer morphs of your nose, and an animations of the morphs, to show the changes that are possible for your nose in truly expert hands in a revision.

I elevated and narrowed the tip. Elevating the tip does two things to reduce the asymmetry. First it makes the nose look smaller, and any asymmetry looks smaller on a smaller nose. Second, the crookedness of your nose is seen along the length of your nose, and if the length is less, the asymmetry can't establish itself as well, and it seems smaller.

And that doesn't even take into account other techniques that can be done to actually improve the asymmetry itself.

You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon, and how to determine whether your previous surgeon should perform your revision.

Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. Then, he must show you before and after photos to prove that he can actually accomplish what he draws on the computer.

Omaha Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Straightening a Naturally Crooked Nose

Regardless of the cause a crooked nose can be surgically straightened. While perfect straightness cannot be guaranteed significant improvement will be achieved if the work is done by an experienced specialist.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Crooked nose

You're asking about a revision rhinoplasty but for a naturally crooked nose.  Was this not addressed during your original surgery or is this a complication from your previous procedure? Revision surgery at this point can certainly help to straighten the nose but scar tissue is hard to predict. If your septum was previously harvested then you might need some rib cartilage to minimize the risk of the nose deviating again. Good luck!

Justin Cohen, MD
Washington DC Otolaryngologist
5.0 out of 5 stars 20 reviews

Is a deviated nose important?

Yes, but not 100% perfectly straight and symmetrical. Significantly better, not perfect. Recurrence depends on what grafts are used. Maybe 10- 20% chance?

But I don't really want to answer your questions. I want to ask you one. If a nose is otherwise good, overall size, tip refinement, suits the rest of the facial features etc etc, and if breathing is good, does it really matter that it is 'deviated'? Who notices it is deviated? When?  Yeah sure, your nose is pretty bent. I understand you might want to do something about it. But if the only beef you had with it at all was that it wasn't straight, I'm just wondering if that's a big enough deal to warrant the risks and uncertainty of a revision procedure. 

Best wishes, Mark.

PS Yes, I often wish the selfie had never been invented. It's got a lot to answer for.

Mark Baldwin, MBBS
Melbourne Plastic Surgeon
5.0 out of 5 stars 12 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.