Crooked Nose Surgery: If You Don’t Know This, You’ll Need Revision Surgery Again.

Hello.

I’m Yoo Young-gi, a board-certified plastic surgeon.

Can crooked nose surgery be done with ear cartilage alone? Can it be done with septal cartilage alone? Is osteotomy of the nasal bone necessary for crooked nose surgery?

When you start looking into surgery because your nose is crooked, you may have these questions because of all the different information out there.

These are also questions that people usually ask during consultations.

In fact, this is truly a case-by-case situation. Let’s look at some cases and see why.

Before crooked nose surgery, it’s important to first have a realistic consultation about how much improvement is possible.

Today I’ll introduce a case. The patient was a man in his 20s, and he said he had learned boxing when he was young, and that repeated injuries at the time made his nose seem crooked.

Looking at the nasal bridge, light reflection usually appears at the highest point, and if you look at the brighter part of the bridge, you can easily see that it is bent from left to right in the photo.

However, rather than immediately judging from the patient’s story alone that this was caused by repeated trauma, we need to think a bit more carefully and decide on the surgical plan.

When we took a CT scan and checked, there were no signs of fracture in the bone.

However, excessive curvature was observed in the septal cartilage area. This could also have been caused by trauma, or it could have been congenital.

And in cases related to boxing, since most people in Korea are right-handed, if we consider the direction of the punches that usually carry the force, it is actually more common for the nose to bend in the opposite direction.

Also, since the size of the nostrils appeared similar, we could not rule out a congenital cause, so we made several plans and proceeded with surgery.

First, to briefly explain crooked nose surgery.

Crooked nose surgery is an operation that corrects a nose that is deviated from the center line and has an uneven shape.

This surgery plays an important role not only in improving appearance but also in improving breathing function.

When the nose is crooked, it can go beyond a simple aesthetic issue and make breathing difficult, while also causing problems such as snoring or sleep apnea during sleep.

Crooked nose correction surgery aims to accurately assess the bone and cartilage structure of the nose and adjust it into the proper position to straighten the center line of the nose.

In this process, not only the external appearance of the nose but also the function of the internal airway is improved, making breathing easier.

The surgical method varies depending on the condition of the individual’s nose and their needs, and it may involve osteotomy of the nasal bone to adjust its position or repositioning the cartilage.

What matters is that in cases where the deviation is severe, like the case I’m introducing today, strong materials are always needed. Even if the change appears minor from the outside, there are many cases where major reconstruction is needed inside.

Rather than viewing it as a simple cosmetic procedure, it is more appropriate to see it as a reconstructive surgery.

If you try to rebuild a column using a soft material from the very beginning, it often collapses again, leading to revision surgery.

If we look at what strong materials are available here, there is still no excellent material in modern medicine that can replace autologous rib cartilage.

In some cases, MESH or donated rib cartilage (taken from another person’s cadaver) is used in surgery, but since both are foreign materials, side effects are always reported along with them.

Rather than first considering foreign materials, I think it is better to consider substitute materials only when autologous rib cartilage absolutely cannot be used in special cases.

The surgery may take about 2–3 hours, and if autologous rib cartilage is used, it may take 1–2 hours longer.

After surgery, a splint is attached to the nose for about a week to help the new structure stabilize.

Immediately after surgery, there may be swelling, bruising, and discomfort, but these gradually decrease over time.

Most patients can return to daily life within a week after surgery, but it takes several months to fully recover and see the final shape.

Crooked nose surgery offers major benefits not only in appearance but also in function.

Because proper breathing is essential for a healthy life, this surgery often significantly improves a patient’s quality of life after the correction of a crooked nose.

However, thorough consultation is essential before deciding on surgery. Not only consultation, but the patient should also study and learn about it. Please go to consultations after learning some information. To achieve a more satisfying result, you should have enough knowledge to participate in the decision-making process yourself.

Let’s take another look at the patient’s preoperative photos from several angles.

From the side, it is not easy to tell that the nose is crooked, but there is a slight hump. (a convex shape on the bridge of the nose)

And the tip of the nose is a little short, and considering the overall proportions of the face, the nose felt generally small.

What the patient focused on most was improving the deviation.

He also hoped that the nasal bridge and tip would be raised only slightly, without looking too obvious.

I explained the various expectations,

and because the CT clearly showed that the septal cartilage was severely bent and a strong material was absolutely necessary, we decided to harvest autologous rib cartilage.

When I harvest autologous rib cartilage, I currently use a 11 mm minimal incision to collect the cartilage, because the traditional method of making a 2.5–4 cm incision can raise concerns about scarring.

(For thin women, 11 mm is not difficult, but in this male patient, the chest wall was so large that we used a 15 mm incision...)

This is what it looked like after surgery.

The patient said that not only the shape but also breathing had become much easier, and with a bright smile, we checked the progress while talking about what he liked and what was uncomfortable.

Crooked nose surgery is a procedure I can confidently recommend, because it does not just focus on cosmetic improvement, but also improves the functional aspects in many cases. :)

If you’re curious about a hump nose, please also read the post at the following link!

https://blog.naver.com/youngkeeyoumd/223378498155

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Roy Plastic Surgery complies with medical law. The photos in this post were taken under the same conditions, and are images taken with the patient’s prior consent. In addition, after plastic surgery and procedures, side effects such as bleeding, infection, and inflammation may occur depending on the individual, so caution is required.

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