I have a crooked nose and off-centered midline, what are my options to fix these issues? (Photo)

Thank
you for your question.  Based on your pictures and question, I would
say that would be a good candidate for a rhinoplasty.  The concerns you
raise (the crookedness of the nasal dorsum) can all be addressed with an open rhinoplasty.  During this
procedure, the underlying cartilage and bone are reshaped and reduced in size
to help give more refined appearance to the nose.  Precise sutures can be
placed in the nasal tip cartilages, as well, to help narrow and rotate the
tip if this is needed.  
I
would suggest you consult with a board certified facial plastic surgeon or
plastic surgeon who specializes in rhinoplasty.  Here you will have a full
evaluation and be able to discuss your goals for surgery.  Be sure to look
at before and after photographs, as well.
I
hope that this helps!
-David
Gilpin

Your assessment of your nose is quite correct.  Fixing a crooked nose is tricky.  The most important thing is to identify whether the nose is crooked due to crooked cartilage, bone, or both.  Fixing crooked bone requires osteotomies which breaks the nose to straighten it.  The lower part of the nose requires other interventions such as spreader grafts and perhaps septoplasty. During your rhinoplasty consultation your surgeon will discuss with you the several options available to you.  Good luck!

Hello,
Thank you for your question. Septum is fixed and a more aesthetic appearance can be obtained with the closed rhinoplasty approach without making any incision in the columella. A  more detailed information may be given during an evaluation.
Best Regards.
Bora Ok, MD - Plastic, Reconstructive and Aesthetic Surgeon