Can a septoplasty be done without the need for a rhinoplasty when the nose is visually crooked?

Hi, hope you are well. If you have a severe septal deviation and the external nose is visibly crooked/twisted, then generally it is best to perform septorhinoplasty for the best functional and aesthetic outcome. A septoplasty alone can be performed without changing the external structure of the nose, and can likely improve nasal function, but it might not be the best choice (especially if you are concerned with your nasal appearance). These questions depend on the individual, the shape and severity of the septal deviation, and the structure of the remainder of the nose. Finding a surgeon who performs a high volume of nasal surgery and has good results with this type of nose will be the most important step of your journey.
Cheers,Dr. Tower

If your nose is visibly crooked, having a straight septum is one of the first and most important steps to achieving a straighter nose. This straightened septum can form the basis to rebuild the remainder of the external nose. Changing the external shape of the nose, even straightening it, with just a septoplasty alone isn't usually achievable and additional techniques (rhinoplasty) are necessary for success.
Airflow through the nose is quite complex and can be quite subjective as well. I've seen all sorts of noses of the years and people surprise me all the time. Some tiny noses internally and externally cause no issues with breathing while some larger ones with crazy deviated septums report no issues at all. Of course, the reverse is true as well. Some noses that look wide open and sturdy can sometimes feel quite restricted and congested in some patients.

The nose can be crooked on the outside but you can still have good nasal airflow if the septum is straight. With a severe crookedness on the outside that may not be the case. The septum is the base of the nose, so to have the best chance of straightening a nose from the outside, the septum should always be straightened during rhinoplasty. Be sure to discuss it with a rhinoplasty expert.