What is the appropriate procedure to address my issues with my nose? (photos)

Question

For the longest time I have been insecure about my nose . It deviates to the left and this was concluded by ENTs . It is apparent because my nose is crooked externally . I also have a bump on the left side of my nose bridge . The right alar seems to be caving into to my cheek and looks to be placed lower and was wondering if the cause would be the deviated septum ? I was told my nasal bones are good , but the cartilage is the problem .

Gerald Minniti, MD, FACS · Answer

All of your concerns regarding your nose could be addressed in a rhinoplasty operation. This would include using cartilage graphs taken from your septum, straightening and reinforcing your septum, and securing your nasal tip. The operation would have a likely benefit of improving your nasal air flow as well.

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. You may be a candidate for a septorhinoplasty procedure to correct your deviated septum and aesthetic concerns. During this surgery, the deviation can be corrected by focusing on the internal structures of the nose while also contouring your nose’s overall shape and appearance. 
Please keep in mind that any form of rhinoplasty is one of the most complex of all plastic surgery procedures, requiring experience, skill, and even artistry to achieve an optimal outcome. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to examine your concerns and determine the best treatment option for you.

Oakley Smith, MD, FRCSC · Answer

Rhinoplasty surgery will be the best option for you to improve the appearance of your nose. It is better for you to consult with a facial plastic surgeon who can examine you and discuss how your nose might look after surgery.

Nima Shemirani, MD · Answer

Hi @Beachgal00! Thank you for sending your photos. You would be a great candidate for a septo-rhinoplasty. A rhinoplasty in my opinion is one of the most difficult procedures to perform. The skill, artistry, and technique of the surgeon will determine your outcome. In my practice, I utilize piezosurgery. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. I hope this was helpful!

Selcuk Inanli, MD · Answer

Hello! First of all thank you for your question.Here is the evaluation I can make regarding your photos:You have a nasal deviation to the right and facial asymmetry. On your face, the left side is higher and longer. It is the dominant side. You need a septo-rhinoplasty operation.

Andrew Miller, MD · Answer

From the photos, it appears that your whole nose is off to the right - this includes bone, cartilage, and septum. All three have to be adjusted to make your nose as straight as possible and remove the bumps. Be sure to see a rhinoplasty specialist for consultation

Lucian Ion, FRCS · Answer

Question and sharing your photographs.

The front view photo gives the impression of a high septal deviation to the right end in my opinion would not be corrected bye attempts to straighten the cartilage support alone.

A high septal deviation means that the bony part of the nasal septum is contributing to the external division and ideally should be addressed.

In my practice, ultrasonic instrumentation in rhinoplasty has made a significant difference for the management of high septal deviations

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. You are an excellent candidate for rhinoplasty. I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. it is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. In your case, you want a make sure that your surgeon has experience with crooked noses. The incision in open rhinoplasty heals almost always invisibly. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Zoran Potparic, MD · Answer

It is very likely that you have deviated septum on top of external nose issue. In you case structural septirhinoplasty, which will address both functional (breathing) and aesthetic concerns. In person consultation with a board certified plastic surgen, expert in rhinoplasty, is recommended. Good luck.

Eric M. Joseph, MD · Answer

" Where the septum goes so so goes the nose." Based on your photos, you appear to have a C-shaped nasal appearance. we can also see a small bump on your right oblique facial photo. Please consider visiting several rhinoplasty specialists who offer computer imaging so you could see what might be best for you moving forward. hope this helps! Doctor Joseph