Rhinoplasty Can Fix a Crooked Nose

The Story

I saw a male patient today for a nose surgery consultation who requested a rhinoplasty and septoplasty. He was unhappy with his nose and had great difficulty breathing. He reportedly never had any nasal trauma and recalled that his nose was “perfect” until age twelve. The patient adamantly requested nose surgery to fix the issue, but we had some processes to determine if he was a nose surgery candidate.

Examination of his nasal cavity demonstrated a severely deviated septum on both sides and mild turbinate enlargement. On the outside, he had a very twisted nose, one of the most complex issues addressed during surgery.

The bony structure in the upper one-third of the nose deviated to the right. While the middle third and the lower third, at the tip of the nose, twisted to the left. Lastly, the lower two-thirds, made of cartilage, were almost C-shaped, and the nasal tip was somewhat bulbous and droopy.

I explained that I could improve his breathing significantly by straightening his septum and reducing the size of his turbinates. Furthermore, I explained that I would narrow his tip just enough to improve it while keeping it masculine.

I would also strengthen the tip and raise it a small amount, remove the nasal hump (bump) and straighten the bridge of the nose as much as possible. That’s when he stopped me. “What do you mean, as much as possible?”

Why I Couldn’t Help This Crooked Nose Rhinoplasty Patient

My crooked nose rhinoplasty patient was in more severe shape than usual. Straightening a nose is the most challenging thing in rhinoplasty or cosmetic nasal surgery. In the case of deviation due to trauma, a rhinoplasty can fix a crooked nose very well. However, when the nose naturally develops crooked, it may be impossible. The reason is that the bones may be completely different on both sides.

Rhinoplasty surgery cannot correct this congenital deformity. Also, the middle third, made of cartilage, can be challenging to straighten, as the cartilage can have memory. To correct this, we often use different types of grafts, such as spreader grafts, to camouflage the deviation.

Do not be alarmed or surprised if your rhinoplasty surgeon tells you he cannot guarantee a perfectly straight nose. He is being honest. Be alarmed, instead, if the surgeon makes any such guarantees.

While a rhinoplasty for a crooked nose is helpful for many, I decided to let him go in this case; fixing him would cause even more problems.

How Crooked Nose Rhinoplasty Works

Rhinoplasty surgery is reconstructive or cosmetic nasal surgery, and a facial plastic surgeon performs the intricate procedure. The plastic surgeon will examine your nasal cavity to determine any damage to the bones or septum and evaluate the appearance of your nose to determine if you are a candidate for rhinoplasty.

Rhinoplasty usually requires correcting the crooked nose and deviated septum to enhance facial features and improve breathing. Sometimes, a follow-up rhinoplasty is required to adjust the results. After the physical examination, here is the procedure to perform rhinoplasty for a crooked nose.

• General Anesthesia: The plastic surgeon will discuss the surgical details and the anesthesia during the consultation. General anesthesia is typically used to ensure the patient is comfortable during the procedure.
• Incision: The placement of the incision depends on the extent of the surgery; there are two surgical options, closed rhinoplasty and open rhinoplasty. Whenever possible, most professionals opt for the closed approach to fix a crooked nose internally.

Open rhinoplasty involves an external incision between the nostrils in the columella. The surgeon gently raises the skin and corrects the structure for a straighter nose, adjusts the septum to improve snoring and breathing issues, and makes other cosmetic improvements. During a closed rhinoplasty, the surgeon uses internal incisions to adjust a deviated septum or crooked inner bones.

The nasal bones reveal a crooked nose, and the surgeon transforms the underlying nasal structure into a straight nose. While patient results and recovery time vary, it may take up to one year for the complete results.

• Reshaping the Nose: The most important part of the rhinoplasty procedure is correcting nasal asymmetry. The nose bone is quite soft, and the nasal fracture can worsen if something goes wrong. The surgeon must carefully and meticulously improve the structure, the appearance, and the inner structure.

In the case of a nasal fracture and lack of equipment, crooked nose rhinoplasty can take a lot of time. Choosing an experienced plastic surgeon with advanced tools and experience is very important.

The upper and lower lateral cartilage create structure, and a nose partition and cartilage grafting are helpful for a broken bone. During crooked nose rhinoplasty, the surgeon often takes cartilage from the ear or ribs to fill the gap and create an asymmetrical nose.

As long as the bone is whole without missing points, nasal fracture repairs don’t take much time. If additional cartilage is needed, the nasal fracture surgery can take longer. An anesthesiologist oversees the patient to ensure they sleep throughout the entire surgery.

• Deviated Septum Corrected: Repairing a deviated septum is an additional step that rarely occurs during crooked nose rhinoplasty. Still, it is needed when the wall between the nostrils, known as the septum, is dislodged during a trauma. This step reduces the projection to improve breathing.
• Closing the Incision: Once the underlying structure of the patient’s nose is corrected and the rhinoplasty changes are complete, it is time to close the incision. Sometimes, additional incisions are needed to alter the nostril size before finalizing the rhinoplasty.

Types of Rhinoplasty for Crooked Noses

Apart from the two primary types of rhinoplasty, closed rhinoplasty and open rhinoplasty, there are also some other methods of cosmetic nose surgery. Closed rhinoplasty is the most common because of its ease and flexibility.

Liquid Rhinoplasty

Liquid rhinoplasty is a less painful and cheaper version of rhinoplasty. A dermal filler can help correct the nose shape and symmetry While this method works well, it has limitations.

Open or closed methods are the best for a broken or crooked nose. However, filler rhinoplasty is an excellent temporary option for patients who want minor alterations that improve their overall appearance.

Secondary Rhinoplasty

If you underwent rhinoplasty and your nose is still crooked or you have trouble breathing, secondary rhinoplasty may be recommended to correct everything.

Secondary rhinoplasty doesn’t always require open or closed rhinoplasty surgery. Sometimes, the surgeon may recommend using dermal fillers or other ways to improve the nose structure and the primary rhinoplasty results.

How Safe is Rhinoplasty?

Rhinoplasty is a prevalent method for nose reshaping and correction. Rhinoplasty is a safe procedure that generates good results when performed by a renowned or experienced surgeon.

However, every surgery has some risks, and feeling scared is natural. Here are some steps you can take to avoid possible problems associated with rhinoplasty.

• Choose the right surgeon
• Follow the doctor’s advice
• Follow pre-surgical instructions
• Follow aftercare instructions

Guarantees for Crooked Nose Rhinoplasty

One problem that every surgeon faces is the inability to predict the difficulty of the procedure. No matter how experienced the surgeon is, they’ll learn the full extent of the problem when they cut the skin and expose the nose.

Even if a surgeon takes every precautionary step, they can’t fully predict how complex the job is. It does not matter which doctor you choose; they won’t guarantee the success of crooked nose rhinoplasty or even minor plastic surgery of the nose.

There are no guarantees, but choosing the right surgeon can reduce the chances of failure and provide the best results. Here are some factors that help determine if rhinoplasty is complicated or straightforward:

• Skin thickness
• Bone, cartilage, and muscle structure
• Blood supply particularities
• Deformities and humps

Rhinoplasty is considered the safest nose correction procedure, but even this process has some issues. Rhinoplasty patients must adhere to all aftercare instructions; improperly handling the delicate nasal tissue and new cartilage or failing to keep the area covered may lead to damage and poor results. Another common cause for poor results is choosing an inexperienced or underqualified plastic surgeon.

Listen to the surgeon and follow their advice after the surgery to care for the healing bones and stitches. Here are some things that might go wrong if you choose the wrong surgeon for your crooked nose rhinoplasty.

• Pollybeak Deformity: Pollybeak deformity is the most common problem you can face if you choose a cheap surgeon for your work. This happens when an inexperienced surgeon overly fills the little dip above the tip of the nose. The nose gets rounded like a parrot’s beak, and the only way to remove the fill is to surgically reopen the nose.
• Wrong Cartilage Size: Cartilage is required to support the tip and fill the gap, but the size of the cartilage should be appropriate. Some surgeons mistakenly use too much cartilage to support the nose, which ends up over-extending the nose tip.
• Knuckling: Cartilage is required to support the tip and fill the gap, but the size of the cartilage should be appropriate. Some surgeons mistakenly use too much cartilage to strengthen the nose, which ends up over-extending the nose tip.

Another problem is knuckling, which happens because of over-cut cartilage on the sides of the nose. Knuckling causes the cartilage to lose its springiness, and the twisted, distorted cartilage creates a knuckle that is visible on the nose.

However, this is an issue that is easy to solve. While an inexperienced surgeon may recommend reopening the nose to cut the excessive cartilage, the weakened cartilage won’t stay there long. A better solution is to replace the cartilage to support the nose.

The problem is knuckling, which happens because of over-cut cartilage on the sides of the nose. This causes the cartilage to lose its springiness, and that twisted, distorted cartilage creates a knuckle that is visible on your nose. However, this is an issue that is easy to solve. The surgeon needs to open the nose and cut the excessive cartilage. A better solution is to replace the cartilage and provide a new one to support the nose. With time, cartilage gets weak, and cartilage that is already cut down won’t stay there for long.

What to Expect After Crooked Nose Rhinoplasty Surgery

Rhinoplasty plastic surgery requires cutting and stitching, so you must take great care of your nose. Otherwise, you might have an infected nose, excess bleeding, or complications requiring a visit to the surgeon and possible rhinoplasty revisions.

You must ensure that your nose is untouched for the first two days. The surgeon typically removes the stitches in one week. In the meantime, take care of the nose and ensure it stays straight.

Patients must avoid activities that increase the risk of harm. The bone is still shaky, and a little jerk could misplace it. Side effects, such as swelling and dark bruises around the eyes, are common. But don’t worry; the surgery’s typical side effects will disappear within two weeks.

Your nose skin will be numb, and you might have trouble breathing for at least 24 hours. Once the stitches are out, you’ll be able to breathe normally, but a stuffy nose will stay with you for some time.

If you had rhinoplasty to repair a broken nose, you must avoid injuring the delicate bones in the nose for at least three months. Within three weeks, you’ll have a vague image of what your nose will look like, and you’ll see the final results after a year.

What to Do After a Crooked Nose Rhinoplasty

Being a rhinoplasty patient requires caring for yourself after the surgery until all symptoms are gone. Rest, proper diet, and medicine are your best friends for the first two weeks.

Rest will help your body to heal, medication will help you avoid infection and reduce pain, and food will give you the energy to recover. Walk daily, and each day try to walk more than before. Take one week off and, if possible, work from home for at least two weeks.

Use two or three pillows to raise your head while sleeping for the first week after surgery. Keeping your head elevated will reduce pressure on the nose, minimize swelling, and protect the newly adjusted bones.

Another thing a rhinoplasty patient must do is to use an ice pack on their nose for 60-90 minutes every day for three days after surgery until the swelling goes down. If you wear glasses, wait to wear them for two weeks or attach a strip of thick tape beneath the frame so it won’t settle on your nose.

For a rhinoplasty patient, avoiding stressful activities is a must. Keep this up for the first two weeks, consult your doctor, and follow his advice.

Refrain from driving until released by the surgeon. If you have an emergency requiring driving, ask the doctor before driving. Here is the most challenging part, as a rhinoplasty patient, you are not allowed to blow your nose for at least one week after the surgery.

Also, ask your doctor if you can bend over, as this puts pressure on the nose, which might worsen symptoms like swelling, pain, and bruising. Do not rub your nose for eight weeks, and refrain from using any cream except for the one your doctor recommends on your nose. If you have to put on sunscreen or makeup, do it gently so as not to hurt your nose.

What to Eat

The surgeon will explain dietary restrictions during the rhinoplasty consultation. The changes completed during the surgery could be shifted or irritated if you eat hard or crunchy foods. Most doctors recommend soft foods during the first week.

As a rhinoplasty patient, you may notice that your bowel movements are irregular after surgery. Try eating simple foods that are easy to digest to avoid constipation and bowel movement strains.

If you can, take a fiber supplement daily, so your bowel movements remain smooth. If you don’t have any bowel movements in two-three days after the surgery, contact your doctor and ask him to prescribe you a safe laxative.

Take Your Medicine

Most doctors prescribe antibiotics to reduce the risk of infection and pain medication. Your doctor will let you know your medicine routine, and if you stick to it, you’ll get better results. Keep updating the doctor with your progress so if a new medicine is required, the doctor will let you know as soon as possible.

As a rhinoplasty patient, you must follow the prescription. If you miss a dose, contact your doctor and follow their guidance. If your recovery is progressing quickly, inform the doctor so they can change the dosage or remove extra medicines. Do not stop taking medication because you feel better or don’t want to.

Always take your medicines after meals for better results unless your doctor advises differently. If your pain medication is not working, don’t just grab a different one; ask your doctor and use the one they prescribed.

Pain, bruising, and swelling will gradually fade over several weeks. You might find it hard to handle, but don’t let it get you down. Take your medicine, rest, and stay positive during the healing process.

Benefits of Crooked Nose Rhinoplasty Surgery

Rhinoplasty is an expensive procedure, but it has multiple benefits that can improve and enhance the look of your nose. Here are some potential benefits of rhinoplasty.

• Change the Size of the Nose: Rhinoplasty is an excellent option to decrease or increase nose size, repair a crooked or broken nose, reduce a hump, or improve breathing. Nasal surgery can help correct the nose structure to make it look better and improve your overall appearance.
• Fix Crooked Nose: Rhinoplasty became famous because it could successfully improve the nose structure to remove the signs of a crooked nose, humps, and bumps, repair broken noses, and improve facial asymmetry.

Closed rhinoplasty, performed internally without external stitches, is beneficial in many cases, while open rhinoplasty surgery allows surgeons to make intricate changes to the nasal system for complex issues.

After open rhinoplasty, the surgeon will stitch the skin with tiny, discreetly placed stitches. The stitching signs will go away in a few weeks, leaving your face with a straight nose and enhanced facial features.

Rhinoplasty is the best option for a crooked nose. Crooked nose rhinoplasty performed by a facial plastic surgeon generates the best results. So, even if the surgeon costs more, the results will be worth the money.

• Give the Nostrils a New Shape: Sometimes, people have breathing problems because their nostrils are narrow. Rhinoplasty can help reshape the nostrils and open them so you can easily breathe. This might require a spreader graft to open and hold the nostrils, increasing the cost.

Sometimes, people realize they have trouble breathing after the rhinoplasty, so a secondary process is necessary. However, the surgeon usually checks the nostrils and corrects them before ending the surgery.

• Reduce the Nasal Tip: An uneven nasal tip is one of the most common reasons people choose rhinoplasty. If you are satisfied with your overall appearance and facial features but find that a sizable nasal tip is ruining your look or causing pain, rhinoplasty can help reshape your nose to an ideal shape.
• Balance Between Other Facial Features: Your nose is like an anchor point that balances your entire face. If your nose is not straight, anyone looking at your face might find it imbalanced.

Sometimes the nose bone stretches the skin or alters the overall shape of the face; rhinoplasty realigns the nose and corrects the form. Rhinoplasty improves harmony between other facial features.

• Correct Deviated Septum: The nose’s central soft bone is the septum, which has to be straight for a proper nose shape. If it deviates, you’ll have trouble breathing, moving your nose will get painful, and any pressure on the nose becomes almost unbearable.

Rhinoplasty helps fix the septum so your nostrils remain open, and you won’t feel pain or have breathing issues.

Risks of Crooked Nose Rhinoplasty Surgery

Rhinoplasty is an excellent surgical option to fix the nose, but it has some risks.

• Complications with Anesthesia: General anesthesia is necessary during rhinoplasty in most circumstances. The surgeon will explain the anesthesia and possible risks during the consultation.

Some people have trouble waking from anesthesia, and when they do, they feel headaches. Side effects are rare but may include nausea, vomiting, dry mouth, sore throat, muscle aches, itching, shivering, and sleepiness.

• Bleeding: Excess bleeding is rare, but the risk of bleeding increases if the area is bumped or touched before it has adequately healed. Sometimes the bleeding requires a second surgery to repair the damage.

The surgeon will warn you and give you precautions to avoid possible bleeding. But, if this occurs and it is your fault, you will have to pay for a second procedure.

• Infection: Your skin is delicate and susceptible to infection after undergoing rhinoplasty. While other areas can be covered, your nostrils remain open. Bacteria can enter your nose, and if there is an opening, it can cause an infection.
• Swelling: Swelling is the most common side effect of rhinoplasty surgery. Reduce swelling by keeping your head elevated. Your nose might also stay numb for several hours. After the numbness fades, touching your nose will cause pain.

The pain and swelling will gradually fade over one to two weeks. But, some residual swelling will remain for up to one year.

• Dissatisfaction with Results: The surgeon explains the expected results during the consultation, and patients must have realistic expectations. However, even if a 3D image showing the desired results is beautiful, there is no guarantee that you’ll like the results in real life.

Some people who have undergone rhinoplasty are dissatisfied with the new shape of their noses. Straightening a crooked nose is different from liking the results. Ask the surgeon for before and after results from other patients, and read reviews before scheduling your surgery.

Conclusion

If you are unhappy with your nose’s appearance, options are available. Rhinoplasty is one of the best methods to correct a crooked nose, a nasal hump, or a broken nose. However, choosing an experienced plastic surgeon to perform the surgery at a hospital or an accredited surgical facility is essential.

You can experience outstanding results from rhinoplasty but expect a gradual transformation as it takes two to three months to see noticeable changes. Taking care of yourself should be your priority as you allow your nose to heal completely. Listen to your surgeon and follow all pre-surgical and aftercare instructions to avoid complications after the surgery and to achieve the best results.

Ask your facial plastic surgeon for before and after photos of other patients, and go into the journey with realistic expectations and confidence in your surgeon’s experience and expertise.