Which procedure would straighten out the tip of my nose after breaking the base of my nasal bone? (photo)

Question

I am wondering if there is any way to just straighten the nose tip without having to break the nose or go through a complicated procedure. I don’t have a deviated septum but some cartilage deficiency on one side following an impact which broke the base of the nasal bone right above my lip.

John Michael Thomassen, MD · Answer

A septoplasty would straighten the tip of your nose.  There may need to be an incision in the columellar skin or just on the inside of your nose depending on what needs to be done.  The bone does not need to be fractured.

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have a reverse C-shaped appearance to your nose. I believe part of this is due to the fact that your tip appears to be veering off to the right side. Depending on your examination, fillers could be considered for improving upon the indentation along your right nasal side wall, however, this would not address your crooked nasal tip appearance. In order to properly reposition somebody's nasal tip after trauma, surgery is typically necessary. I hope this is helpful, sincerely, Dr. Joseph

Gary M. Horndeski, MD · Answer

You can have tip surgery.  However, that will not correct the bone that is fractured.  You would be better off having a complete rhinoplasty done to straighten the bone cartilage as well as the tip.

Best Wishes,

Gary Horndeski, M.D.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. You are an excellent candidate for rhinoplasty and agree with your assessment. In your case, you definitely need a rhinoplasty to fix the crooked nose.  Rhinoplasty is not an enormous operation.  Most times, a rhinoplasty takes only an hour and a half to perform in the recovery is minimal. A large portion of my practice is dedicated to rhinoplasty surgery. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a rhinoplasty to help straighten your nose. There are many different maneuvers that could be used to accomplish this including septal reset. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Jeffrey H. Spiegel, MD · Answer

Great question Mermaid508. Yes, we should be able to just address the tip of the nose without worrying about the bone, but, it depends on what we see in person. If the bone is twisted we will need to address it, but, likely we can do just the cartilage parts which will make the recovery quite a bit quicker.

Zoran Potparic, MD · Answer

Only on the basis of in person evaluation a board certified plastic surgeon with expertise in rhinoplasty would be able to give you a meaningful answer. Good luck.

Nicholas Lahar, MD · Answer

Hi Ms. Mermaid, thanks for the interesting question. I see the tip deviation that you are talking about. Generally, surgical rhinoplasty will be the best and most reliable option for correcting the appearance of the nose. It also does not have to be a tough procedure. An experienced surgeon will be able to make the experience very tolerable.
However, for non-surgical options, depending on the actual defect you have (which is hard to assess with just one photo) it may be possible to fill that defect with some sort of filler, thereby pushing that side of the nasal edge forward and driving the tip back toward your left. You should see an experienced plastic surgeon with injection experience to make sure this procedure is done reliably and safely. The central face has many blood vessels that can be blocked with filler if done improperly.
Best of luck!

Mats Hagstrom, MD (license on probation) · Answer

I don’t think you go to get a quality assessment from the information provided.
I recommend you rely solely on in person consultations with plastic surgeons in your community specialize in rhinoplasty surgery.
If the problem stems from fractured nasal bones, then the treatment option most likely is going to be to address your previous fracture.
 if you concern the way your nose tilts to one side or the other and you need to look at the nose in context to facial a symmetry, which is usually down underlying baseline. If you’re concerned is the contour of your tip tip rhinoplasty may be appropriate.
Look for plastic surgeons were members of the society or those who practice is either exclusively focused on rhinoplasty surgery or rhinoplasty surgery is a , major part of their work.
Look for those who have at least one to two decades of experience.
Bring pictures of yourself to use as reference for each consultation.
Do not rely. I’m looking in mirrors or memory of what your nose looks like.
During each consultation, ask each provider to open up their portfolio and show you the retired collection of before, and after pictures of previous patients who had similar facial characteristics for whatever procedure the surgeon is recommending.
Highly experienced providers should have access to hundreds of before and after pictures to choose from.
Schedule consultations with multiple providers before choosing a provider or considering scheduling surgery.
The biggest mistake I see patients make scheduling only one consultation and then scheduling surgery.
Having only one consultation, more or less eliminates the ability to choose a better provider.
I don’t think patients do a very good job at selecting providers and I don’t believe you can properly vet providers by using the Internet.
In the end provider selection is by far the most important variable trade.
I suggest you focus your efforts on that one sink variable 
Good luck,
Mats Hagstrom MD

George Lefkovits, MD - Account Suspended · Answer

The nose is a three dimensional structure and you only showed one view, namely the frontal view. It would be important to examine your nose by a Board Certified plastic surgeon with lots of experience performing rhinoplasty. It may be possible to just attend to the tip but only after fully examining the entire nose.Good luck1

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