Q: Dr. Eppley, My nose has been broken a couple of times, and I have a deviated septum. I am curious what it would take to straighten everything out–and what it would look like.
A: Based on this one picture, I have done some imaging based on what I think is achieveable in an open septorhinoplasty procedure. Straightening a crooked nose is one of the most difficult challenges in all of rhinoplasty because it is never just one element of the anatomy that is off. It is never simple and requires a complete dismantling of the support structures and rearrangement. This means an open septorhinoplasty with septal straightening and graft harvest, inferior turbinate reductions, nasal osteotomies, spreader grafts to the middle vault, a columellar strut and nasal tip narrowing. As you can see your nose would be much straighter and as assessed by the flow of the dorsal lines from the forehead down to the tip of the nose.
Dr. Barry Eppley
Q: I am in the beginning stages of considering the possibility of rhinoplasty procedure. A large nose runs in my family, but what I’m most unhappy with is that my nose is slightly crooked. I also wouldn’t mind some size adjustment, both length and width. I am truly unsure of what potential costs for something like this may be. I am 30, single and have limited income. Can you provide me with more information that may be helpful to me at this point in my process? I would certainly consider a consultation, and would be extremely interested in seeing photos of what you could do with me, if possible.
A: Rhinoplasty for the crooked nose is one of the more challenging nose operations. This is because a very crooked nose is the result of more than one part of the structural anatomy that accounts for why the nose is not straight. It usually involves a deviated septum, middle vault asymmetry and right down to a twisted tip. It is not usually possible to just fix a deviated septum and have the whole nose.then become straight. Crooked noses involve every cartilaginous element and often the bone as well. For these reasons, correction of a crooked nose involves a full septorhinoplasty.
While computer imaging can make a crooked nose perfectly straight, rhinoplasty surgery is not like Photoshop. It is best to think of a straighter but not perfect crooked nose result than to undergo surgery with the expectation that it will be perfectly straight. While that is the goal, there is a reason (bent and deformed cartilages) that the nose was crooked to start with. And cartilage does have memory so some relapse or recoil may occur even out to 6 months after surgery.
Dr. Barry Eppley