When You Make the Osteotomies and You Realign the Nasal Bones Does the Cartilage Part Follow As Well ?

Hello, i had an accident (7 months ago) that left me with a crooked nose so I'm considering rhinoplasty . I think it's in the bony section but my ENT doctor said it might be cartilage as well .So , when you straighten the bones will the cartilage follow the movement (and come to a straighter mode as well) or there is another technique for that ? (like rasping or cut it) (sorry for my english) (i want the less possible work in my nose cause im really scared)

Doctor Answers 8

Nasal cartilage does follow bones during osteotomy

Yes, when osteotomies are performed, the upper lateral cartilages do follow inwards with the nasal bones.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Does Cartilage Follow the Bones with Osteotomies?

If osteotomies are done the cartilages attached to the bones (the upper lateral cartilages) will move with the bones, but your deviated septum will not be corrected. Therefore, without a septoplasty your nose will still be crooked. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Broken nose

All of your posted photos are shot angled upwards and off true frontal so it is hard to tell what nasal components are out of position. When you do the osteotomies to move the nasal bones some of the nose cartilage moves with the bone others like the septum do not. It is really not a relevant question because frequently even the osteotomies are not enough to get the desired result and crushed cartilages grafts are required to mask residual indents in the bone and rasping is required to remove fracture spurs in the bone. The surgery is individualized for the patient and there is no cookie cutter one size fits all approach that will work.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review

Cartilage And Bone Movement with Rhinoplasty

That is a great question.  The answer is yes, the upper lateral cartilages will move together with the nasal bones.  They are firmly attached to one another.  However, that does not mean that the upper lateral cartilages are going to be where you want them after moving the bones.  There may need to be some direct intervention on the cartilage.

However, if your nose was straight before the injury, there is a good chance that when the bones are moved back, the cartilage will follow nicely.  Typically when you have an injury, the cartilage is not damaged.  The cartilage is soft and very flexible so it tends to just bend and then spring back.  The bones, obviously, do not bend and spring back.  So once the bone is broken and moved, it stays moved unless someone puts it back.  And since the cartilage is attached to the bone, it stays moved as well until the bone is moved back.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
4.9 out of 5 stars 30 reviews

When You Make the Osteotomies and You Realign the Nasal Bones Does the Cartilage Part Follow As Well ?

Osteotomies are to realign the nasal bones to the midline and are performed above the upper lateral cartilages.  If these are crooked and from your photos they do appear to be so, these must be addressed directly.  The nasal tip is also a bit wide with flared nostrils, IMHO.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Rhinoplasty and crooked nose


   I am very glad that you have asked this question.  Becoming educated about the desired procedure will allow you to ask the right questions during a consultation, should you choose to proceed with the next step.  Just as important, researching general opinion about your question may make it easier to receive a surgeon’s recommendations regarding your specific anatomy. 

  Correcting displaced nasal bones is an entirely different procedure than correcting displaced cartilage.  Nasal bones that are crooked can be refractured with osteotomies, set into proper alignment, and held in place with a rhinoplasty cast.  In contrast, cartilage cannot just be placed back in the middle and be expected to stay there.  Cartilage has memory.  For example, when you fold your ear in half it will spring back to its original position.  The same will happen with a deviated segment of nasal cartilage that is simply pushed into the middle.  It will spring back into a crooked position.

  Correcting deviated cartilage can require repositioning the septum, stabilizing spreader grafts and advanced techniques.  Fixing a crooked nose is a challenging procedure and is best performed by a specialist that devotes a large part of his practice to rhinoplasty.

Christopher Kolstad, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Rhinoplasty for the crooked nose.

Rhinoplasty for the crooked nose involves osteotomies for the bone and the cartilage often needs a septoplasty for the cartilage. See an experienced surgeon for the best results.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Realigning the nose

Sometimes the cartilage moves back with the bone, but usually it needs to be freed as well in order to go back to the center. This is usually pretty straightforward, but may require what's called a septoplasty in order to allow it to move and to stay where it is moved.

Verne Weisberg, MD
Portland Plastic Surgeon
4.5 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.