Twisted NoseTwisted Nose
Correcting a twisted nose to make it perfectly straight is a very difficult surgery, requiring an experienced facial plastic surgeon. Dr. Azizzadeh is a nose specialist and one of the leading experts in primary rhinoplasty and revision rhinoplasty.
A twisted nose usually causes functional issues, but patients often also desire nose tip reshaping when they come to Dr. Azizzadeh for help with functional issues. At the time of the consultation he will evaluate the patient’s nose both for its aesthetics and function, as many patients will have nasal airway obstruction and breathing difficulties because of a fractured septum and internal nasal vault collapse.
What is a twisted nose?
Most crooked nose deformities involve poor aesthetics in the transition between the nasal bone, which makes up the upper portion of the nose, and the nasal cartilages in the middle nasal vault. The middle nasal vault is very sensitive to damage in trauma, as the cartilages in that area can easily be avulsed and separated from the nasal bone. Hence, the aesthetics of the nose appears to be crooked as the nasal bone is still maintained in the middle portion whereas the nasal cartilages are separated. Due to this, people often describe a twisted nose as having an “S”-shape.
What causes a twisted nose?
Properly diagnosing the cause of a twisted nose is imperative to correctly treating the nose. A crooked nose can be a result of the following:
- Trauma: Nasal bones are the most commonly fractured bones in the face. Trauma is a leading cause of an asymmetrical nose.
- Disease of the septum and internal nose: Disease can cause reabsorption of supporting structures leading to the collapse of nasal valves and deviation.
- Postsurgical: A twisted nose can results after a rhinoplasty surgery.
Many patients who have previously sustained a fractured nose and have previously undergone close reduction of nasal fracture will require definitive treatment of their persistently twisted nose. Furthermore, many patients who have undergone full rhinoplasty procedures for a twisted nose may continue to have some evidence of crooked nose and as a result will seek further secondary or tertiary rhinoplasty procedures to address their persistently twisted and crooked nose deformity.
Most patients for revision rhinoplasty and a persistently crooked nose do not have problems with their nasal bones per se, but rather have persistent problems with their nasal cartilages in the middle portion of the nose, also noted as a middle nasal vault.
In addition to aesthetic deformities, a twisted nose causes nasal obstructions and functional issues. It is very important for Dr. Azizzadeh to address the functional issues of the nasal airway that are associated with a twisted nose, while also improving external deformities. Since he is an expert nose doctor, Dr. Azizzadeh is able to successfully restore functional issues for most patients.
How is a twisted nose fixed?
During a consultation with Dr. Azizzadeh, he will examine the patient’s crooked nose and diagnose the best surgery plan. For proper and effective treatment, Dr. Azizzadeh develops a comprehensive plan that takes in to account balance, proportion, symmetry and correction of nasal function.
During the time of the revision rhinoplasty, Dr. Azizzadeh will reconstitute the middle nasal vaults utilizing spreader grafts and suture grafts to better align the middle nasal vaults to the nasal tip as well as the nasal bones. If the nasal tip is also in a crooked position, the septum and the cartilages of the nasal tip will be reconstructed to bring the entire nose into alignment with each subunit. Occasionally if the nasal bone is still persistently crooked, deviated and asymmetric, then the nasal bones need to be re-fractured (undergo osteotomy re-fracture). The fracture of the nasal bone often requires differential fracturing of the right and left side in order to bring the nasal bones back into the middle portion and in balance with the rest of the nose.
If you have a crooked nose that you would like to correct, schedule a consultation with expert nose surgeon Dr. Azizzadeh. The correction of a crooked nose is incredibly complex, so trust your face to renowned Beverly Hills facial plastic surgeon Dr. Babak Azizzadeh.