Can Septoplasty Straighten the Tip of the Nose?

Question

Only the tip of my nose veers slightly on the left. It's just a little bit (something that I can notice and bothers me but most people can't notice). I am getting a septoplasty and sinus surgery. Will the septoplasty straighten the tip? Is it crooked because of the septum? Or would you have to get a Rhinoplasty to fix this?

C. Spencer Cochran, MD · Answer

There are several reasons why a patients nose can look crooked.  If the septum (cartilage dividing the nose into a left and right half) is deviated (crooked) then that can cause the outside to look crooked. The septum can be deviated in one or more locations. If only the lower half  that is near the tip is crooked it can push the tip to one side.
Another reason that a tip can appear crooked is that the paired tip cartilages are asymmetric. You should seek the advice of a surgeon who specializes in rhinoplasty to make sure that the diagnosis is correct.
While it is possible to correct deviation of the lower/out part of the septum with septoplasty, rhinoplasty techniques may provide a more reliable result.

Anil R. Shah, MD · Answer

The crooked nose is one of the most difficult things to correct in rhinoplasty.  There are several anatomic causes of a crooked nose:

	
		Deviated septum- Note for this part to be corrected by a septoplasty the surgeon must address the dorsal or caudal aspect.  Most routine septoplasty does not address this (see link below)
	
		Asymmetry of nasal tip cartilages
	
		Asymmetry or deviation of nasal bones

Peyman Solieman, MD · Answer

Dear Colorado1985,
As is often the case, it really is not possible to tell you for sure if septoplasty can straighten your nasal tip, but we can tell you that in our own experience, we've had a few cases where simply correcting the septum did straighten the tip. This is however relatively rare, and in our experience only occurred in a few patients who had a septal fracture in the front part of the septum. In general these are not simple septum repairs that can be corrected via a routine septoplasty, but rather need to be approached through  an open approach. 
In those cases, if the septum is straightened and there is no scarring or memory to the tip cartilages that would keep the tip twisted, you can have a straighter nose. However, all this being said, we find that in general, most of our patients have needed a Rhinoplasty that focused on the tip in order to genuinely get a straight  nasal tip.
In your particular case, if the tip is only slightly twisted it may possible that septoplasty alone will help in making the tip straighter.
I hope this helps
If we can be of any further assistance please feel free to email us any more specific questions.

Richard W. Fleming, MD (retired) · Answer

Yes, a deviated septum may cause a "crooked" nasal tip. However, this appearance may be secondary to asymmetry of the tip cartilages. Pre-operative evaluation should clarify what you can achieve with the septoplasty.

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