Can a severely deviated septum where breathing is not disrupted, be straightened with non-surgical procedures?

Please consider re-asking you a question with photographs. If you have a crooked initial appearance from a deviated nasal septum, but your breathing is OK, sometimes fillers may be applicable. Hope this helps! Sincerely, Dr. Joseph

Hello and thank you for your question. Honestly, surgery is the best option to address your situation- previously broken nasal bones with septal deviation and a visibly crooked nose, as you mentioned. Fillers would be the main non-surgical option, and they would only partially mask the appearance of a very mildly crooked nose, but would make it appear wider in the process, would not address the septal deviation, and are only temporary in nature. The shape of your nose is due to the underlying anatomy present- a combination of your nasal bones and cartilage makes up the structural framework of your nose, including the septum and the support for the dorsum and the tip. Correcting nasal/septal deviation, and addressing the shape of the nose (especially the nasal dorsum and nasal tip) are actually two of the most common reasons people seek out and undergo a rhinoplasty procedure, which would provide optimal results to achieve your goals.

In addition to addressing your aesthetic nose concerns, your septal cartilage (or an off-the-shelf alternative) would be harvested (removed) and turned into multiple cartilage grafts, which would then be secured into different areas of your nose for structural support, including in the columella (middle bottom portion of your nose between your nostrils) to really reinforce the tip and prevent long term alterations/distortions to nose shape. These grafts would also functionally reinforce your internal nasal valves to improve breathing (and prevent disruption).

The open approach is very effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery. I would only recommend going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.

Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photos and description provided.

Dr. Donald Groves, our expert facial plastic surgeon, has extensive training and experience with complex rhinoplasty surgeries, so I’d recommend for you to come see him (or another plastic surgeon who is extremely comfortable with rhinoplasties) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Emer

In a non-surgical nose job, injectable fillers are used to change the shape of the nose and improve overall facial harmony. In most cases, fillers are used to change the appearance of the nose and camouflage certain areas.  We are not able to change the actual shape of the underlying bone and cartilage with the non-surgical nose job, and a non-surgical nose job does not typically affect (positively or negatively) nasal breathing.  Anyone looking into this procedure should consult with an expert injector who also performs many rhinoplasty surgeries.  All the best,

Hello and thank you for your question and photographs.  It appears that your nose is deviated with some asymmetry.  You may benefit from filler injection, but this is only temporary and will require continuous re-treatment.  Also, with each injection, there is a risk of arterial occlusion, ischemia, and other complications, more so than normally, because your nasal anatomy, and thus the vasculature, is likely distorted.   If you want a permanent fix, I would suggest finding the right aesthetic plastic surgeon to evaluate you for a rhinoplasty.  An aesthetic improvement, if performed carefully, is unlikely to compromise your breathing.  In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome.

After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on male rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS

Harvard-trained Board Certified Aesthetic Plastic Surgeon

QUICK ANSWER: Yes, it is possible to "fix" a deviation with a properly performed nonsurgical rhinoplasty using fillers (e.g., Restylane, Juvederm, Radiesse, etc.). This is done by filling in contour irregularities, such as concavities, to create the illusion of a less crooked nose. 
LONG ANSWER:  Depending on the severity of your asymmetry (will be better assessed in person and with standard rhinoplasty photography), as well as your goals and expectations, you may be better suited for either surgical or non-surgical rhinoplasty. I think the best thing to do would be to consult a physician who is experienced with both surgical and nonsurgical rhinoplasty techniques, that way you will receive an unbiased and expert opinion. Moreover, since you are worried about not making your breathing any worse, it would be wise to consult with a surgeon who performs both cosmetic and function septorhinoplasty on a regular basis (e.g., specialty training in Facial Plastic Surgery or Plastic Surgery). As an aside, I routinely counsel patients during their pre-operative rhinoplasty consultation that their is a very small chance of making the breathing worse; however, this would be rare and I can almost guarantee that their breathing after surgery will be either the same or better than what it used to be. 
Take home point: both surgical and nonsurgical rhinoplasty have their separate advantages and disadvantages. It is up to you, the patient, with guidance from an experienced surgeon, to determine which modality would be best for you.Hope this helps!
Blake Raggio, MD