22, uneven nasal bones, breathing issues. What are my options? (Photo)

You don't have a crooked nose, you have an assymetrical nose; in fact all the left side of the face seems to be smaller than the right side: the orbit, the eyebro, the nose, the nostril and the nasal bone on the left side are smaller, noticeably, and this has no solution, with no technique, and in no one's hands.This assymetry makes the left wall of your nasal "tent" be shorter, thus making the nose also lean to that side; with a rhinoplasty and suitable osteotomies this might experience partial improval, but never total. You have to accept this fact.Otherwise, you are a case for the so called "basic rhinoplasty", endonasal, to shave the dorsum, narrow the pyramid with osteotomies and trim the alar cartilages of the tip, also shortening a bit the tip projection.If you have breathing impairment and this is due to the septal deviation (this is not visible externally, in person examination needed) you could add a septoplasty, otherwise it is not indicated.All the above via closed approach; open rhinoplasty in your case just shows inexperience or lack in technical confidence in the surgeon.

you certainly have quite a deviated nose and this reflects an underlying deviated septum in all likelihood so will require a full functional and aesthetic septorhinoplasty

Congratulations on taking the first steps towards rhinoplasty, and becoming educated on realself.Your pictures indicate that you would likely be an excellent candidate for an open rhinoplasty surgery.  Your surgeon will likely recommend some refinement of the nasal tip and removal of a dorsal hump with possible osteotomies.  If there is nasal obstruction secondary to structural issues in the nose, likely you can undergo a functional surgery covered by insurance, and your surgeon may be able to add on the cosmetic maneuvers at an additional cost to you.  Seek consultation with a qualified facial plastic surgeon who specializes in nasal breathing issues as well as cosmetic rhinoplasty.Best wishes.

Thank you very much for sharing your concerns with us.The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.With this procedure you get a delicate nose, better harmonize with your other facial features.Respectfully,Dr. Emmanuel Mallol Cotes.-

 A rhinoplasty procedure can accomplish making the cosmetic changes to the nose such as addressing the asymmetries in the bridge line, shaving down the dorsal hump, and adjusting the lower lateral cartilages of the nasal tip. The nasal bones can also be straightened from their slanted position. There are many  factors inside the nose that can cause breathing issues, such as a deviated nasal septum, turbinate hypertrophy, valve collapse, vestibular stenosis, allergies, and chronic sinusitis. Each one of these issues are treated differently  with either medications and/or surgery. Rhinoplasty is a very difficult endeavor, so choose your surgeon very wisely based on extensive experience.

Thank you for your question. It sounds like you definitely have both functional and aesthetic issues to resolve. My advice would be to find a suitably qualified board certified plastic surgeon in your local area.From what you describe I suspect you will need a septorhinoplasty.Kind regards,Ivo

If you want cosmetic improvement as well, this can be accomplished with correction of what sounds like your collapsing internal valve.  Best of luck. Do your homework and fine a good surgeon!

The key is finding a rhinoplasty surgeon who is also experienced in taking care of breathing issues. In order to have a straight nose you need to have a straight septum.  Almost all surgeons experienced in rhinoplasty will make sure that the septum is straight when a rhinoplasty is performed. Sometimes, if the turbinates (the tissue inside the nose) are large, they will need to be reduced at the same time. In doing your research, make sure that you are seeing surgeons who are good at both things. Good luck.

Provided that you are otherwise healthy and there aren't any mitigating factors, you appear to be a good candidate for a primary rhinoplasty. Your narrow nasal bones, prominent dorsum and boxy/asymmetric tip can all be addressed through a variety of technical maneuvers that a qualified/reputable rhinoplasty surgeon should be able to articulate to you.When you retract on your collapsed side and improve airflow, you are opening up the internal valve of your nose....this is called a 'Cottle Maneuver'.....there are many elements to this valve and hence several surgical steps that can be taken to improve it's function through rhinoplasty....perhaps even more importantly, your primary rhinoplasty must be thoughtfully planned and executed so as to avoid worsening any functional and/or cosmetic issues that you have....I firmly believe that ALL rhinoplasties should be functional...furthermore, I have found that looks and function are never far apart from one another in rhinoplasty surgery.Take your time and be sure that your surgeon has:1. many years of rhinoplasty practice experience2. judgment and techniques that have evolved over time3. practice focused on rhinoplasty 4. willingness to do difficult, secondary and reconstructive cases5. interest in teaching others how to evaluate and do rhinoplasty properly6. willingness to share rhinoplasty resume, photos and patient experiences with prospective patient

There is a high likelihood of some degree of septal deviation contributing to you issues. A consultation and external and internal nasal examination is the only way you can know what needs to be changed in your situation.