What is a “step-off” deformity, what causes it, and what can be done to fix it?

Hello and thank you for your question.  A step-off deformity is a palpable and sometimes visible indentation between the transition of the nasal bone and upper lateral cartilage.  It can be fixed by either rasping the bone or placing a spreader graft.

Best wishes.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Dear wherehaveigone,
Thank you for your question. Stepoff deformity means where on exam you can feel by palpation or even an uneven area to the nasal bones that one area is depressed or higher compared another neighboring area. It can be caused by nasal bone fracture or nasal surgery where the nasal bones had to be fractured. It can improved during surgery by shaving down the area that sticks out or by re-breaking the bones or by placing other material like a cartilage or soft issue graft to camouflage it. I recommend you seek an in-person consultation with a facial plastic surgeon or plastic surgeon who is a rhinoplasty specialist who can perform a thorough evaluation and discuss with you the best surgical treatment options to meet your goals.

Astep off deformity is a palpable or visible step like defect of the nose. Can be between the nasal bones an upper cartilage of the nose most often can be fixed bt rasping. Can be improved with a filler such as juvederm. I have also used fat injections to mask this defect. Good luck.  

Dear wherehaveigone,A "step-off" deformity in reference to rhinoplasty usually defines an area where the nasal bone has been broken, typically during a previous rhinoplasty, and there is literally a step like separation between the two edges of the bone.  Oftentimes the step off is palpable (i.e. you can feel it), but not visible.  Correction typically involves rebreaking the nasal bones.  It can sometimes self correct if the injury or surgery is relatively recent, or it can be corrected with filler materials.  Good luck!

A step off deformity is a malalignment of the nasal bones, classically at the dorsum. It can be caused by an impact injury, such as dropping a heavy object on the nose, a car accident or an assault.

Hi and welcome to our forum!
A step off deformity of the nose usually involves the nasal bones where one can feel (and sometimes see) a change in alignment of the nasal bones adjacent to the maxilla following injury or surgery. If the bones are otherwise in alignment, the irregularity can be rasped smooth. If the bone itself is visibly malaligned, surgical revision is required.
Best wishes...