Why a depressed nasal bone on one side makes the nose look crooked: Osteotomy reconstruction and septal reconstruction

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient who came to our clinic concerned about facial asymmetry, a crooked nose, and a depressed nasal bone. In particular, the right nasal bone was depressed, requiring reconstruction through osteotomy.

• Main concerns: Facial asymmetry, crooked nose, nostril asymmetry

• Key findings: Depressed right nasal bone

• Correction of the crooked nose and nostril asymmetry

• Reconstruction of the depressed right nasal bone

• Minimal change in tip height (patient request)

• Natural balance

1. Reconstruction of the depressed right nasal bone via osteotomy

Because the right nasal bone was depressed, facial asymmetry was severe. Through precise osteotomy, the depressed area was restored and bilateral symmetry was achieved.

2. Correction of the deviated septum

The deviated septum, which was the fundamental cause of the crooked nose, was corrected. Straightening the septum accurately aligned the midline of the nose.

3. Septal reconstruction and extension using autologous rib cartilage

The septum was reconstructed and extended using autologous rib cartilage. This created a stable support structure while making only the minimal change in tip height requested by the patient.

4. Concurrent chin augmentation

Chin augmentation was also performed to improve overall facial balance.

5. Nasolabial angle correction

The nasolabial angle was adjusted to improve the appearance of the protruding mouth, making the profile line much more refined.

Frontal changes:

• Restoration of the depressed right nasal bone improved facial symmetry

• The crooked nose was straightened

• Improvement of nostril asymmetry

Profile changes:

• Improvement of protruding mouth through nasolabial angle correction

• Overall balance improved in harmony with the chin surgery

• Nasal tip height was changed minimally as requested by the patient

Nostril changes:

• Correction of left-right asymmetry

• The columella was aligned to the midline

For this type of case, correcting facial asymmetry was the key focus rather than a simple cosmetic rhinoplasty.

Nasal bone reconstruction through osteotomy

Restoring a depressed nasal bone is very delicate work. It is not just about pushing the bone upward; it must be returned to an accurate position while considering harmony with surrounding structures. In this case, because facial asymmetry due to the depressed right nasal bone was severe, it was accurately repositioned with osteotomy to achieve left-right balance.

The importance of correcting a deviated septum

A crooked nose is not just an external concern. It frequently occurs because the internal septum is deviated. Therefore, if only the external appearance is corrected without straightening the septum, it can become crooked again over time. In this case as well, fundamentally correcting the deviated septum supported a stable, long-term result.

A patient-customized procedure

The patient requested minimal change to tip height. Respecting this preference, tip height was adjusted only minimally even during septal reconstruction with autologous rib cartilage. Respecting the patient's individual characteristics and requirements is paramount.

I will continue to provide customized surgery that closely reflects each patient's individuality and requests through this meticulous approach.

This was Dr. Peter C. Kang. Thank you.

#closedrhinoplasty #closedrevisionrhinoplasty #crookednosecorrection #facialasymmetry #nasalbonereconstruction #osteotomy #autologousribcartilage #deviatedseptum