Septoplasty Vs Rhinoplasty for Crooked Nose?

I have a crooked nose. Will Septoplasty fix it or will I need Rhinoplasty as well? Are there any closed options available? Looking at my picture, if I get Septoplasty, should I get Rhinoplasty anyway to make my nose smaller?

Doctor Answers 29

Correcting a Crooked Nose

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

Dallas Facial Plastic Surgeon
4.7 out of 5 stars 145 reviews

Rhinoplasty vs. Septoplasty

Rhinoplasty is a purely cosmetic procedure that is designed to improve the appearance of the nose. Insurance generally will not reimburse patients for this procedure. Rhinoplasty is generally performed for a variety of reasons including: correcting a hump in the nose, straightening the nose, or correcting the width of the nose.

Conversely, septoplasty surgery corrects a deviated septum. The primary purpose is to help a patient breath more easily. This procedure is generally considered medically needed and may be covered by insurance.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 39 reviews

Septoplasty and Rhinoplasty are often done together.

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,


David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Rhinoplasty, Septoplasty, or Both for Crooked Male Nose?

Hi Carter,

You need to decide if the external appearance of your nose bothers you. If it does, other than the crookedness, then you need to decide what features are bothersome, and what you would like it to look like after rhinoplasty. You should only make your nose smaller if it is something that has troubled you for some time.

Occasionally just straightening a deviated septum will correct a crooked nose. If the nose remains crooked after septoplasty, then other techniques are necessary to straighten the nose. It may require osteotomies (breaking the nasal bones), or adjustments to nasal cartilage. It may require the addition of grafts.

Most importantly, take your time to choose your nasal surgeon very carefully.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Nose and septum

It is tough to tell accurately from just a single picture and no physical examination.

Your nasal bones appear deviated. This should typically be repaired in addition to the septum. Also of any other aspects of the nasal appearance bother you, that would be the time. It would be a shame to throw away valuable nasal septal cartilage if it might help in the reconstruction of a droopy tip..

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 177 reviews

Septoplasty does not usually change the appearance of your nose.

If you're happy with the appearance of your nose, then you don't need a Rhinoplasty. If you'd like your nose straighter, and smaller, then Rhinoplasty would be suitable.

If you have chronic nasal blockage on one side only, then your septum is probably deviated towards the side of the blockage. Repairing that alone would not likely change the external appearance, but could improve your breathing.

I hope this helps, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Septoplasty vs Rhinoplasty

Great questions. Generally speaking a septoplasty does not change the external appearance of the nose. Thus a crooked nose usually requires a rhinoplasty in order to improve the symmetry. The only caveat is in patients with repeated nasal trauma such as hockey players or boxers. Those patients usually have a near completely  calcified nasal septum. In those patients I have found that straightening the septum will in fact improve the symmetry or straighten the nose to some degree. Hope this helps. 

Julian W. Dixon, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Septoplasty Vs Rhinoplasty

The very nature of the two procedures is completely different. A septoplasty is primarily designed to alleviate a patient who is suffering from breathing problems caused by a deviated septum. Meanwhile, a rhinoplasty is for more aesthetic changes to the nose, altering the size and shape of the nose to conform more closely to the rest of a person’s facial features. If you are looking to correct a crooked nose, you are most likely a candidate for a rhinoplasty. Still, for a more accurate assessment of which surgery would be best for your situation, schedule a consultation appointment with a board certified doctor to evaluate your condition in person.

David O. Volpi, MD
New York Otolaryngologist

Meet with a surgeon to decide what's best for you...

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.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Crooked nose

The septum is the part of the internal structure of the nose. Addressing the septum will help improve your airway. Sometimes this is enough to help a patient. However, if there are structural problems with the nasal bones or cartilages, further surgery (rhinoplasty) will be necessary.

Sandy Sule, MD
Dallas Facial Plastic Surgeon
4.3 out of 5 stars 13 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.