My nose goes crooked when I smile due to severely deviated septum. Will a septoplasty fix this? (Photo)

My nose is slightly crooked when my face is relaxed but when I smile it really curves to the side that my septum is deviated. I've noticed it get worse as my septum has become more and more deviated over the years. I literally cannot breathe out of my left nostril. I don't mind my nose a bit crooked when my face is relaxed and do not want a rhinoplasty but I want to know if correcting the deviated septum will also straighten out my nose when I smile.

Doctor Answers 7

Deviated nose

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Nasal deviations are very commonly due to septal deviations although asymmetries in the lower or upper cartilages or bones can sometimes be the cause.  A septoplasty can sometimes correct a deviation, but if the septum is deviated in the remaining L strut after a septoplasty, then grafting in this area will be necessary.  I would recommend to plan on a complete rhinoplasty and not just a septoplasty to correct a deviation. 

Crooked Nose

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A crooked nose as you describe can largely be due to a deviation of the septum, but correcting the breathing component may not have a full impact on straightening the nose. Many times the upper portion of the septum (the dorsum) needs to be addressed and straightened, which is what is done in a rhinoplasty. Furthermore, once the septal cartilage has been altered, it is possible that the dynamics of the tip support will result in unaesthetic changes to the tip that should be addressed as well but that is your decision.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.7 out of 5 stars 145 reviews

Crooked septum and tip deformity during smiling

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Septal deviation is only part of the story. You appear to have a very active depressor muscle that pulls your tip down and out when you smile. Removal of this muscle and fixation of your tip cartilages with respect to the septum (once it is straightened) is the best option to stabilize your nose. In other words, your need a full septorhinoplasty to address your septum / tip.

Grigoriy Mashkevich, MD
New York Facial Plastic Surgeon

Grigoriy Mashkevich, MD
Manhattan Facial Plastic Surgeon
4.7 out of 5 stars 10 reviews

Rhinoplasty for septal deviation.

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A septorhinoplasty will straighten your nose and improve your breathing if done by an experienced rhinoplasty surgeon. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Crooked nose when you smile

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Without a better set of photographs and examination of the septum it impossible to tell. The septum can be deviated at the caudal most portion and this can be causing  what is known as a "caudal septal deviation". Your nose could also be crooked due to a stronger smile muscle on one side of the nose then the other. It's important  to examine the entire septum by looking on the inside of the nose at the time of examination and consultation. For more information, diagrams and our  photo gallery, please see link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

A deviated septum can cause breathing difficulties as well as a crooked nose

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The nasal septum is the center supporting structure for the nose. When it is considered "deviated" we are referring to the central portion that controls the airway. When the internal part of the septum is crooked, the outside is often crooked as well. This outer area is what makes the nose look crooked externally.
What's more interesting is that typically the nose tilts externally to the opposite side of the internally deviated septum and nasal blockage.
Fixing a "deviated septum" from a functional and insurance point of view will help breathing but not external tilting of the nose. That requires more complex surgery and a rhinoplasty to correct. You should see a septorhinoplasty specialist for an evaluation and qualfifed medical opinion.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Crooked septum, crooked smile

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It is possible that your smile might be a bit straighter after a septoplasty.  It is absolutely possible to make a functional and cosmetic change with a septoplasty alone in some cases.  This is why anyone who operates on the nose should be a master of septal work, IMHO.  Thanks.

Matthew Bridges, MD
Richmond Facial Plastic Surgeon
5.0 out of 5 stars 26 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.