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

Question

My nose is crooked towards left side and my midline is towards right side how can these two problems solved?

David Gilpin, MD · Answer

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

Bora Ok, MD · Answer

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

Philip S. Schoenfeld, MD, FACS · Answer

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!

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well.. based in your question and the picture you showed you are a good candidate for rhinoplasty with technique open with refined the tip. and elevate the tip.

Paul E. Goco, MD · Answer

Thanks for your question and photos. Your concerns would definitely be able to be corrected with a rhinoplasty. Please see a qualified rhinoplasty surgeon for an assessment and recommendation.  Good luck!!

Tanveer Janjua, MD · Answer

A rhinoplasty and septoplasty can fix the crooked nose. However keep in mind that it is sometimes not possible to get a 100% straight nose even after surgery. Since your nose is not very crooked you might be better off leaving it alone.Regards Dr J

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty.  This can be designed to improve the symmetry of your nose.  If your septum is deviated, this could also be contributing to your asymmetry, and this can also be corrected during surgery.  Make
sure you specifically look at before and after pictures of real patients
who have had this surgery performed by your surgeon and not just a computer
animation system.  You should be able to
view numerous pictures of actual patients with noses similar to yours performed
by your surgeon.  
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Jeff Markey, MD, FACS · Answer

Thanks for your question. The nasal dorsum being slightly off-midline is one of the most common concerns for patients seeking nasal surgery. From. Your picture you may be a good candidate for “endonasal rhinoplasty”. With this, the nose is straightened through incisions hidden inside the nose.

Deepak Raj Dugar, MD · Answer

Hello!
Thank you for your question and pictures. A closed rhinoplasty procedure is the best option for someone who is looking to straighten a crooked nose without the risk of having any cuts or scars. It is a bit difficult to accurately diagnose what exactly is needed to be done to your nose based off the one picture you submitted. I recommend going to a Plastic Surgeon that specializes in closed scarless rhinoplasty (preferred by actresses and celebrities) because there is no risk of external scarring and much less healing and recovery time. All the same surgical maneuvers your nose requires can be performed with a skilled closed scarless surgeon.

Best of luck, 
Deepak Dugar MD
ScarlessNose Institute of Beverly Hills

Jonathan Kulbersh, MD · Answer

Your nose could be improved with rhinoplasty, which would give permanent improvements in symmetry and shape. You can bring the pictures that you think would be flattering to your face and these can be discussed.  It takes special interest and study to understand the facial aesthetics to create a nose that is harmonious with your other features. Take the time to find the right facial plastic surgeon and ask them to create digital images of the nose they propose for you and discuss the cost.
Hope this helps.

Philip J. Miller, MD, FACS · Answer

I would recommend starting with a consultation with a board certified facial plastic surgeon that specializes in rhinoplasty surgery to discuss if rhinoplasty can address your concerns. 
I would recommend writing down the following questions before scheduling your consultation:
1. Are you unhappy with the tip of your nose? 
2. Do you feel that your nose is too wide? 
3. Do you want to make your nostrils smaller in appearance? 
4. Are you looking to decrease the general size of your nose?
I hope some of these questions will help you pinpoint what it is that you don't like about your nose.  Cost will vary due to various factors like anesthesia fees, facilities fees, etc. I wish you the best as you research your options when scheduling a rhinoplasty consultation.
Sincerely,
Philip J. Miller, MD, FACS Double Board Certified Facial Plastic Surgeon

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