I've heard fixing a crooked nose is more complicated, is this true? (photos)

Hi @T.H. Thank you for sharing your photos. You are an excellent candidate for a rhinoplasty.
I recommend seeing an expert rhinoplasty specialist for an in person examination. There are several options for you that can be determined after examination.

Best of luck,

Dr. Nima

I crooked nose usually results from a deviated septum. Do you have difficulty breathing on either side of your nose? If you do, I strongly advise you have it fixed.
I would recommend starting with a consultation with a board-certified facial plastic surgeon that specializes in rhinoplasty surgery to discuss if rhinoplasty can address your concerns.
I would recommend writing down the following questions before scheduling your consultation:
1. Are you unhappy with the tip of your nose?
2. Do you feel that your nose is too wide?
3. Do you want to make your nostrils smaller in appearance?
4. Are you looking to decrease the general size of your nose?
I hope some of these questions will help you pinpoint what it is that you don't like about your nose. Cost will vary due to various factors like anesthesia fees, facilities fees, etc. I wish you the best as you research your options when scheduling a rhinoplasty consultation.

Sincerely,
Philip J. Miller, MD, FACS Double Board-Certified Facial Plastic Surgeon

Thank you for your question. You are right on. Straightening a crooked or twisted nose is always more challenging than say refining a tip or reducing the bridge. However, rhinoplasty surgeons are trained to correct this using a variety of techniques, most often using cartilage from your septum. Moreover, cartilage has memory which the surgeon must take into consideration. Ultimately in these cases, I advise patients that their nose will most likely not be "perfectly" straight, but if dramatic improvement is acceptable, then surgery may be worth it. I hope this helps, and I wish you all the best.
-Dr. P

Thank you for your question. It is true, that fixing a crooked nose can be more challenging. Our goal is always to get a nose 100% symmetric, but it is one of the hardest things to do. In the hands of an experienced rhinoplasty surgeon, however, a straight nose is possible. At my practice, we use imaging software to show patients what they can expect after surgery which helps to meet patient expectations and to ensure we are on the same page. The most important thing is to find a board-certified facial plastic surgeon who specializes in rhinoplasty. Best of luck!

A nose that grows crooked will be more difficult than a nose that was straight once, but got fractured into a crooked position. However, a well performed rhinoplasty can almost always make a nice improvement while making your nose look smaller at the same time. No one can guarantee it will be perfectly straight, but it should be better while looking natural at the same time.

Consistently straightening a crooked nose is quite difficult. There are many strategies used and they seem to be hit or miss no matter who does the surgery and which technique is used. I’ve looked at enough websites photos and revision rhinoplasties to know that nobody gets all their noses straight. However your nose could be made straighter than it is but not necessarily perfect

You asked if straightening a crooked nose is more complicated.
Yes, and No.
Getting the nose dead straight, and keeping it there while it heals, is not always achieved, despite a surgeon's best efforts.The casts we use do not stay on for the 6 weeks it takes for the bones to set (although after 2 weeks they are pretty stable).If you bump the cast, (or just roll over in bed ) it can shift with the nose. More complex casts (as used to be used decades ago) move with talking, eating and smiling, so they are worse - they do not keep the nose perfectly stable.
(I personally try not to fully mobilize the nasal bones, so the nose takes quite a force to move it, even immediately after the operation).
We can usually get the nose (almost) perfectly straight, provided the septum is straightened at the time of Rhinoplasty, and most will stay where we leave them.Sometimes they need a bit of "massage" a few times a day during week 2, to get them to stay straight - rarely do they need a formal manipulation under Local or General anesthesia, on day 7-10.

Hi there - great question!. A crooked nose is a very common finding that nasal surgeons address. Particularly, it requires a very meticulous attention to detail both for internal nasal anatomy as well as external nasal anatomy. The nose has connection points to the upper jaw, particularly along the nasal tip, and an experienced surgeon will take the time to relocate this connection point with proper techniques. This will help to realign the nasal tip more towards the "facial mideline". A straight nose must have a straight septum as well, and a surgeon with extensive **functional** nasal surgery experience will be skilled enough to perform a very thorough and adequate septoplasty as part of the cosmetic rhinoplasty (together called - septorhinoplasty). However, with any nasal crookedness, there is a limit to how much straightening can be anatomically achieved, as any inherent facial asymmetry will translate to the nose somewhat. In rhinoplasty surgery, the goal is improvement, not perfection. A skilled surgeon will point out to you, using professional photographs, where the nasal axis will straighten, and where other facial asymmetries cannot be fixed with nasal surgery alone. However, these facial asymmetries (such as the position of the chin, and upper lip) may continue to make the nose not thoroughly aligned with the middle of the face. This is probably the most essential part of the pre-operative discussion. I hope this helps you, and good luck finding an experience facial surgeon with extensive experience in reconstructive and cosmetic nasal surgery.

In a case like these, we perform an open rhinoplasty, because it is the best way to analyze all the nasal structures. To do this, you have to make a small cut in the skin of the columella that joins those inside the nostrils to be able to take off all the skin from the cartilage and bones.To correct the deviation of the nasal bones, they must be fractured and moved. Currently we carry out a very precise technique that allows cutting the bone without injuring the nasal mucosa.Finally, it is not more difficult to operate a crooked nose, since each patient requires a personalized method and thanks to our extensive experience, the result will surely be natural-looking and successful.

Fixing a crooked nose: how difficult it is to fix a crooked nose depends on the cause of the crookedness. If the crookedness is limited to the upper 1/3 of the nose and is due to a nasal fracture it is usually rather easy to fix. If on the other hand the entire nose is crooked due to a deviated septum the procedures to correct this are somewhat more involved and less predictable than for example reshaping a profile. The very crooked nose cannot always be made perfectly straight. I tell my patients with very crooked noses that some residual Cookedness may persist. In many cases this may be minimally perceptible but in some cases may call for a secondary surgery which may involve the insertion of a onlay graft or some other, usually minor procedure.