How complex is rhinoplasty to repair what is know as "saddle nose"? (Photo)

Question

I have a bump on my nose followed by a sort of scooped out depression in the bottom half, towards the tip. When researching rhinoplasty I found out that this is known as "saddle nose" and that I might have developed this when I broke my nose as a child. I would like to reduce the bump and refine the tip of the nose, maybe turning it up a bit or shortening it. Is this a complex case that requires someone extremely experienced? I have attached two photos from two different angles. Thank you!

Oakley Smith, MD, FRCSC · Answer

Hello,
You will benefit from surgical rhinoplasty. The hump can be reduced to give you a straight or slightly curved bridge. This will correct the depression (saddling) appearance. The tip can also be refined and turned up a little. It is better to consult with a facial plastic surgeon and discuss how you might look after surgery.

Mehmet Durmusoglu, MD · Answer

First of all, thanks for your question. The saddle nose is featured by a loss of height of the nose because of the bridge's collapse. The most common cause is nasal trauma and previous unsuccessful rhinoplasty. Your photos do not look compatible with the saddle nose deformity. You have a bump on the nose and an over-projected nose tip. And you are a suitable candidate for the ultrasonic rhinoplasty technique. Best regards&hellip;

Jeffrey Lisiecki, MD · Answer

A saddle deformity is a very specific type of deformity usually caused by loss of structural support from the nasal septum. Usually, they are much more dramatic in appearance than this, and the result of severe trauma, incorrectly performed prior rhinoplasty, or prolonged cocaine use causing a septal perforation. Your photos don't appear consistent with this. You have a dorsal hump and a supratip break. This is a fairly standard rhinoplasty, though all rhinoplasties are complex and should be performed by plastic surgeons with specific training and experience in rhinoplasty. Find a plastic surgeon you like, and see them for a consult to discuss your best options.

Timothy Ortlip, MD · Answer

Saddle nose deformity can be very difficult to fix. It is typically caused by a weakness in the underlying structure/septum. We often see this in cases of prior surgery or from trauma. Certain medical conditions can cause this as well, but that is more seldom. Patients with saddle nose may or may require rib (Autologous or Cadaveric) and or other tissue to correct this. You definitely want to find someone more experienced for saddle nose correction. These surgeries can take 1-2 more hours than your typical rhinoplasty.

Barry M. Weintraub, MD, FACS · Answer

As a board certified plastic surgeon who has been performing rhinoplasty surgery, as well as  revision rhinoplasty surgery, for decades, I would advise you to meet with several experienced board certified plastic surgeons. Cases that involve traumatic deformity are complicated and should be left to the experts. A physical exam is the only way to determine exactly what would be needed to correct your issues. Very likely a filing of the bump, a trimming of the lower-lateral cartilages, along with a possible graft could be helpful. It is always a good idea to bring to your consultation pictures of noses you like to best communicate what you would like to achieve.

Zoran Potparic, MD · Answer

It does not look that your nose is very complex for correction. In person consultation with a board certified plastic surgeon with good reputation in rhinoplasty, is recommended. Experience of a surgeon does metter, particular in rhinoplasty. Hope this helps.

Ronald Schuster, MD · Answer

A saddle nose deformity is caused by the collapse of the septum. The septum gives the support of the center of your nose. Is can collapse from several different reasons. Trauma is the most common. When the nose is broken, the septum can also be broken/fractured. This can either dislodge the septum or can cause it to "dissolve" partially. Also when the trauma occurs when you are a child it can stunt the normal growth of the septum. Other causes include snorting drugs, excessive use of vasoconstriction medicines like Afrin, and certain infections. The correction depends on how bad the collapse is and how much healthy septum is left. Sometimes it requires additional cartilage grafting which then requires taking cartilage from te ear, rib, or cadaver donated cartilage. A consultation with an experienced rhinoplasty surgeon is your best bet to get the best advice. Good luck.

Andrew Miller, MD · Answer

I wouldn't call that a saddle deformity - it's just the anatomy of your nose. Saddle deformity usually comes as a result of trauma or previous surgery. At any rate, you are a good candidate for rhinoplasty, where the bump can be taken down and nose made shorter. If certain areas of the nose need to be better supported, that can be done at the same time. Be sure to see a rhinoplasty specialist for consultation.

Gianfranco Frojo, MD · Answer

This is not a saddle nose deformity. This just a small hump that is made up of cartilage and a bony cap. This would not be a complex case for that reason.

Ajaya Kashyap, MD · Answer

Thank-you for your question.  A saddle nose can be improved with cartilage grafts, from the septum, the ear or the rib. Minor degrees can be improved with ear cartilage grafts or nasal septum grafts (if available). When there is collapse of the septum and major degree of saddle nose, rib grafts are the best option. Please find an experienced Board certified Rhinoplasty surgeon who can help you with all your concerns. All the best!

How complex is rhinoplasty to repair what is know as "saddle nose"? (Photo)

Answers (13)