Septoplasty Vs Rhinoplasty for Crooked Nose?

In general, where there's a crooked or skewed external appearance, there's also a skewed or deviated septum. Typically, both the septum and the external framework of the nose need to be addressed at the same time. This, of course, means septoplasty and rhinoplasty (a.k.a., septorhinoplasty).
Closed approaches may work just fine, but my general preference is an open approach, especially for the crooked nose.
One important factor to consider, though, is whether the face itself is skewed. In some patients with a crooked nose, the actual problem is that the whole face is shifted...think of a parallelogram, for example versus a rectangle. In those cases, creating a vertically straight nose is going to be both impossible and inappropriate, but it's important that ones surgeon identifies this before surgery and discusses it with him. I hope this makes sense.
All the best,
--DCP

If external deviations or cosmetic concerns are also a goal from surgery then a rhinoplasty should be contemplated. There are valuable structural cartilages in the back part of the septum which can be used to reshape the nose and if just a septoplasty is performed which usually results in removing those cartilages without addressing those issues there will be some bridges that are burnt!

It is often difficult to say what specifics of nasal surgery might be required based on photographs alone. Seeing the patient in person, evaluating the nasal airway (the inside of the nose), and palpating different areas of the nose is almost always required. Septoplasty can help to straighten the portion of the nose closer to the tip in some cases, but may often require movement of the nasal bones as well in order to facilitate moving the septum back into the midline.With respect to open versus closed techniques, this really comes down to surgeon preference and patient anatomy. I perform both techniques, and decide the preferred technique based on the individual patient's anatomy.All the best,

The vast majority of patients who have crooked noses have
suffered nasal trauma.When this
situation arises the nose should be critically evaluated. Not only should nasal aesthetics be evaluated,
but attention should be given to the nasal airway as well.Under these circumstances, the cartilaginous
nasal septum may be deviated with resultant airway obstruction.When a
patient has a crooked nose following nasal trauma, the nasal septum and nasal bones
are usually both involved. In many
cases, patients often develop a dorsal hump as well.Correction of this problem usually requires a
rhinoplasty.If significant deviation of
the nasal septum is present with associated nasal airway obstruction, a septoplasty
is necessary as well.In rare
cases, a crooked nose may be caused by a deviated nasal septum in the presence
of unaffected nasal bones.Under these
circumstances septoplasty alone may correct the problem.In
patients with post traumatic nasal deformities with associated functional
impairment, consultation with a board certified plastic surgeon is
appropriate.It’s appropriate to address
both aesthetic and functional concerns.

Thank you for your question. Septoplasty is a
surgical procedure which generally entails modification of the cartilage of the
nasal septum. It is undertaken to improve symptomatic nasal airway obstruction
when deviation or crookedness of the septum is judged to contribute to those
symptoms. In most cases, septoplasty will not improve a crooked nose. If you
find your nasal appearance to be unsatisfactory due the crookedness, you may be
a candidate for rhinoplasty. If you find your nose overly large, rhinoplasty
may be considered to diminish nasal size. Rhinoplasty is undertaken to improve
the shape and/or size of the nose, and is usually required to improve nasal
crookedness. For individualized advice, consult with a qualified nasal surgeon
about your concerns. Good luck to you.

A septoplasty is reshaping of the cartilage of the nose, while a rhinoplasty is reshaping of the nose itself.  There are definite gray areas where a septoplasty and rhinoplasty can overlap, however, in general a septoplasty affects breathing while a rhinoplasty affects external shape.

If the desire is to create the straightest nose possible, often a septoplasty is combined with a rhinoplasty.  A deviated nose may have a deviated septum which likely needs to be addressed to help straighten your nose.  However, there are other components which can lead to a deviated nose including the nasal tip, nasal bones, etc.  This would be separate from a septoplasty and be considered a rhinoplasty procedure.  

Thank you for the question and your photo. Septoplasty is generally performed from inside the nose ("closed") and involves straightening the cartilage/bone in the septum to improve nasal breathing. In many case, the deviated or damaged portions of the septum need to be removed, while preserving the lining of the septum.  With a traditional septoplasty, no changes to the external nose are expected.  In the case of a crooked nose, typically from trauma, a "septorhinoplasty" may be indicated. In this procedure, the nasal bones may be reshaped using controlled fractures (osteotomies) to realign the external nose. In more complex cases, cartilage grafts may be needed to improve the airflow in the nose and/or the symmetry of the external nose. In these situations, an open approach is generally preferred.

The terms septoplasty and rhinoplasty can be very confusing for patients.  Truly treating a crooked nose involved separating the five major aesthetic structural units from eachother, the paired upper lateral cartilages, the paired lower lateral cartilages and the septum.  Once this is completed, a submucuos resection of the central septum is completed.  It is only after these steps that the forces and form of each structure can be evaluated and treated.  The components are reattached using suture techniques to balance forces and grafts from the resected septum.  A rhinoplasty for crooked nose therefore technically always includes a septoplasty and a septoplasty alone will simply not treat a crooked nose efficaciously.  I hope this helps!

 

All the best,

 

Rian A. Maercks M.D.

Septoplasty will improve breathing and will sometimes improve asymmetry of nostrils but if the whole nose is asymmetric then a rhinoplasty is also required. The approach can be opened or closed depending on the extent of the problem and your surgeon's preference.

A septoplasty is a surgery performed to correct a deviated (or crooked) septum. A true "septoplasty" does not involve changing the shape of the nose. The septum is the piece of cartilage that separates one side of the nose from the other. Normally, the septum is straight. When it is crooked, it is termed a deviated septum. A deviated septum can block the nasal passage and contribute to symptoms of nasal obstruction.
Correction of a deviated septum with a septoplasy involves making an incision on the inside of the nose. The skin covering the septum is lifted off the cartilage and the deviated setpum (intranasal part only) is either removed or reshaped to make the breathing passages more open. It is infrequent that a septoplasty alone will correct external crookedness.
For post-traumatic nasal deformities, particularly ones in which both the nasal bones and the septum are crooked, a septorhinoplasty (in which both the septum and the nasal framework are corrected) may be required.
Your best bet is to visit with one or more rhinoplasty specialists to make sure that your diagnosis is correct

Nasal surgery is complex and there is no way to tell without more information if you need septo or rhino, or both. Septoplasty may be required to not only straighten your nose, but also improve your breathing. Then there is the issues of your turbinates, which may also need to be addressed at the time of septoplasty. The rhinoplasty may mean bone and cartilage reduction, also moving the entire nasal complex with osteotomies (bone cuts). The closed option is possible, but there is more control and visualization with an "open" approach. There would be little downside to an open approach on your nose, as the "scar" issue would likely be minimal.
Personally, I perform septorhinoplasties with my ENT colleague where he addresses the septum and turbinates, and I peform the cosmetic and functional rhinoplasty. The more complex the deformity, the more chance that he I will be working together to deliver the best form and function.