Deviated nose (crooked nose)

Nasal deviation, or a crooked nose, is a common concern that prompts individuals to consider rhinoplasty. This issue may or may not be associated with functional problems and can be purely developmental or the result of an injury.

As our facial features are never truly symmetrical, a slight deviation to the left or right is necessary for maintaining a balanced appearance, even after surgery.

In general, various parts of the nose can be deviated separately or together. The bony bridge, also known as high deviations, is one of the more challenging areas to address. However, ultrasonic rhinoplasty has made it more manageable, especially in cases of high septal deviations that involve deviation of the whole nasal pyramid. This advanced technique offers opportunities for improvement in alignment and symmetry while preserving a narrow nasal bridge.

The middle vault is supported by cartilage, where the septum plays a significant role in the deviation. The nasal base and tip are influenced by the lower part of the septum, the configuration of the tip cartilages and their asymmetry, and the direction of the anterior nasal spine.

Severe asymmetries or those resulting from injury, which may also lead to damage to the supporting structures, can benefit from additional cartilage grafts sourced from outside the nose, such as rib or ear cartilage. Moderate asymmetries in previously un-operated noses can typically be managed by reshaping and reconfiguring the bone and cartilage support of the nose.