How can a C-shaped dorsum be fixed?

Question

How can a C-shaped/crooked dorsum be fixed other than using spreader grafts?

Eric M. Joseph, MD · Answer

Sometimes a crooked nose will become straight after performing lateral osteotomies during rhinoplasty surgery. If this is not the case, and if there is a persistent indentation along one of the side walls, a cartilage spreader graft is typically placed in between the nasal septum and upper lateral cartilage to provide a straighter nasal appearance. I hope this helps! Sincerely, Dr. Joseph

Semih Yildiz, MD, FEBOPRAS · Answer

A C-shaped or crooked dorsum is usually a structural problem, so the treatment depends on where the deviation originates—septum, nasal bones, upper lateral cartilages, or several areas together. Spreader grafts are one way to support and straighten the middle vault, but they are not the only possible tool. Depending on the examination, a surgeon may use septal correction, asymmetric cartilage or bone reduction, controlled osteotomies, suture techniques, camouflage or onlay grafts, or other structural grafts. Sometimes a combination is needed to straighten the nose while maintaining an adequate airway.

A photo or the phrase “C-shaped” is not enough to choose the operation. The surgeon should examine the external nose, septum, internal nasal valve, breathing, and skin/soft-tissue envelope, and review any prior surgery. If the deviation is mainly functional, preserving or rebuilding support is particularly important; aggressive reduction alone can worsen obstruction.

I would obtain an in-person assessment from a surgeon experienced in functional and revision rhinoplasty. Ask what structure is causing the curve, how the airway will be protected, what graft material is proposed, and whether the goal is straightening, improved breathing, or both. Filler may camouflage a minor contour irregularity but does not straighten the underlying framework or reliably improve breathing.

Gary M. Horndeski, MD · Answer

The crooked dorsum does not necessarily need to have spreader grafts. It can be compressed with a device which compresses the periosteum and results in straightening of the crooked dorsum. Also, a portion of the septum is removed as well.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Kristina Zakhary, MD, MSc, FRCSC · Answer

Thank you for your question regarding options for correcting a C-shaped or crooked nasal dorsum in rhinoplasty. While spreader grafts are commonly used to address such deformities, other surgical techniques may also be effective, depending on the specific anatomy and needs of the patient.
Alternative methods include the use of cartilage grafting techniques, such as onlay grafts or structural grafts, to reinforce and reshape the nasal framework. Additionally, techniques like osteotomies (controlled bone cuts) can help realign the nasal bones to create a straighter appearance. Suturing techniques may also be employed to adjust and stabilize the nasal cartilage without the need for spreader grafts.
The appropriate approach depends on a detailed evaluation of the nasal structure and the desired outcome. I recommend consulting with a facial plastic surgeon who can assess your individual case and advise on the most suitable method for achieving a balanced and natural result.
I hope this information is helpful, and I encourage you to discuss these options with your surgeon for further guidance.

Zoran Potparic, MD · Answer

Nose augmentation with cartilage grafts or solid silicone implants is the best way to correct dorsum concavity. This is a very challenging surgery and you will need a top rhinoplasty surgeon to evaluate and treat you. Good luck.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. It depends on your specific anatomy. There are many very different maneuvers that can be used in combination to correct this. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Emine Demir, MD · Answer

The technique depends on the case, but usually we prefer using the ultrasonic nose shaping technique (Piezzo)

Mats Hagstrom, MD (license on probation) · Answer

There’s no yes or no answer to your question.
It all depends.
I suggest including pictures if you want an assessment.
Best,
Mats Hagstrom MD

How can a C-shaped dorsum be fixed?

Answers (8)

More Rhinoplasty Questions

If it takes 6 weeks to heal, why are casts taken off at 7-10 days?

1 year post op and still dealing with a leaky nose - what could be causing this and how can it be corrected?

Can a caudal projection graft be removed?

How do I decide between 2 surgeons that have 2 different opinions? (Photo)

Open rhinoplasty 8 months - revision needed? (Photo)

Piezo or normal osteotomy?

WE SEND PRETTY
EMAILS