Options to straighten deviated nasal tip? (photo)

Hellooo. After an osteotomy follow nasal fracture, the tip of my septum is deviated to the left. It makes one side of my nose more full than the other; making it look wider to me, and my tip contours are weird. I'd like to get it straightened. Is it possible to straighten just the tip of the septum. What are the options/techniques available?. And do any of these techniques come with risk for other cosmetic/functional issues? Thanks. (Sorry for the graphic photo haha.)

Doctor Answers 10

Rhinoplasty for the tip of the septum

Straightening  and repair of this area of the tip of the septum should only be done if this is causing and nasal obstruction or a visible deformity from the external portion of the nose. Also important to make sure there is no other cartilage  from the nasal tip creating an external deformity. This anterior septal deformity can be simply shaved down.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Rhinoplasty and Septoplasty Will Probably Be Successful.

Dear Chicagocubs:

Ah, there is someone with a name close to my heart because I am originally a Chicago native and, of course, attended many Cubs games at Wrigley Field.

Your description is clear.Your photo is helpful.Do not worry about the "shock value" of the graphic because you have shown me something that is probably very significant.It is certainly possible that the tip of the septum being off center and to the left is causing a shift of the tip of the nose.It would make the tip look wider.The trick is to visualize the change at consultation where, after the nose is anesthetized, a little pressure on the septum might prove to be therapeutic, with respect to placing the tip back in the midline.

The options or techniques are available for a revision rhinoplasty and septoplasty.The nose has to be "taken apart" a bit, but do not let that scare you.The reason is the surgeon must isolate the tip from the front part of the cartilaginous septum to determine if the tip itself is asymmetrical, abnormally structured, or is the result of being "pulled over" by the deviated septum, which you actually demonstrated pretty clearly.

As I indicated above though, generally at consultation, the surgeon can sort out these issues.That brings me to the subject of a complete consultation. At the complete consultation, the inside of the nose should be anesthetized so the surgeon can freely touch the tissues to test the strength there, see if there is any absent tissue and get a sense of what the structures are like.It is very hard to do if the nose is not anesthetized.One has to get a sense of the strength of the tissues, whether or not they can be altered to allow the resumption of a midline position spontaneously.

This is all part of the consultation that will be extremely important for you because you do not want to go through an operation and not have the odds favor success.

Your problem is not that uncommon.All of us who do a lot of nose surgery have seen it.Visit my website and you will actually see some examples of very similar situations and, of course, visit other surgeons' websites because you want to learn as much as possible.I urge you to read the two books I wrote (listed below) because they were designed for patients like you to help you get up to speed and understand the issues.

Do your homework.Spend a lot of time reviewing photos on websites and learning as much as possible.Do that "upfront" before you consult, and you should limit your consultations to those surgeons who "major" in nasal cosmetic and functional surgery. Look for those surgeons who do more noses than any other procedure in their practice. Those surgeons do a lot of rhinoplasties, septoplasties, correction of deviated septums and repair of broken noses.It helps a lot when you are in the right pew in the right church.

Best wishes (still waiting for the Cubs to be in the World Series),

Robert Kotler, MD, FACS
Over 4,500 nasal procedures performed

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 86 reviews

Deviated septum and nasal tip

Often a fracture will involve the septum, or unmask a deviation in the septum not noticed before. The septum can be corrected and this might also straighten the tip as well.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Deviated tip versus deviated septum

A nose can have a deviated septum with or without affecting the shape or position of the actual tip of the nose. Sometimes there can be a combination of both problems occurring at the same time.  It is important to identify what the problems are to understand the complexity of the repair that may be necessary to perform. A deflection in the septum can be handled by a procedure called a septoplasty. Misshapen or deviated tip cartilage can usually be fixed with a combination  of scoring, grafting, and suturing. Your first step is to seek out the attention of a Board Certified Plastic Surgeon that has experience with these procedures. 

Michael A. Epstein, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 48 reviews

Nasal Tip

There are several options available to straighten the nasal tip.The technique that would be best for your specific case would depend on your present anatomy.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

Options to straighten deviated nasal tip?

There are a variety of surgical techniques that can be utilized to straighten a deviated septum and nasal tip. The optimal procedure would depend on your individual anatomy.

Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Correction of Deviated Septal Tip

The tip or caudal end of the septum can be straightened by a variety of simple techniques that don't require an extensive open rhinoplasty approach. A better picture of the nose would help determine exactly what technique would be best.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Deviated septum

A deviated septum can be treated to make it straighter through various techniques.  Best to discuss this in person. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Options to straighten deviated nasal tip?

   The picture is not sufficient to make any recommendations about tip symmetry issues.  The caudal septum can be repositioned in combination with tip suturing techniques to help the symmetry.

Find a board certified plastic surgeon who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Deviated Septum

Based on the one picture, it does appear that your septum is deviated to the left obstructing the left nasal passageway. A deviated septum can cause asymmetrical fullness in the nasal tip.

Besides surgery, there is no other procedure to straighten the septum. Chances are that a straight septum will create a more symmetrical nasal tip. 

Consult a Board Certified Plastic Surgeon

Best wishes

George C. Peck, Jr, MD
West Orange Plastic Surgeon
4.8 out of 5 stars 22 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.