Why a deviated septum causes both nasal obstruction and a crooked nose, and how reconstruction is performed

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient who suffered from severe nasal obstruction due to a septum severely deviated to the left, alongside concerns regarding a crooked nose, a dorsal hump, and maxillary protrusion.

1. Past medical history: Adenoidectomy 20 years ago

2. Main concerns:

• Severe nasal obstruction due to a septum severely deviated to the left

• Crooked nose (nasal bone asymmetry)

• Dorsal hump

• Drooping nose

• Maxillary protrusion

3. Key considerations: A case involving both functional issues (nasal obstruction) and cosmetic concerns

• A straight and natural nose

• Correction of deviated nose

• Correction of the drooping nasal tip

• Overall elevation while maintaining a natural appearance

• Functional improvement: Relief of nasal obstruction

1. Septal reconstruction using autologous rib cartilage

The septum, which was severely deviated to the left, was reconstructed using autologous rib cartilage. Because the septum serves as both the central support of the nose and the core airway passage, rebuilding it sturdily with the patient's own cartilage established a long-term stable structure.

2. Crooked nose correction and lateral osteotomy

A lateral osteotomy was performed to correct the nose deviated by nasal bone asymmetry. By repositioning the nasal bones into their precise alignment, a straight bridge line was achieved from the front view.

3. Dorsal hump correction

The dorsal hump was smoothly shaved to ensure a continuous, refined profile line.

4. Improvement of maxillary protrusion through nasolabial angle correction

The area of maxillary protrusion was naturally improved through nasolabial angle correction. Adjusting the angle between the nose and the upper lip restored overall balance.

5. Correction of the drooping nasal tip

By adequately elevating the nasal tip using autologous rib cartilage, the drooping appearance was resolved, creating an overall refined impression.

• Relief of nasal obstruction via septal reconstruction (functional improvement)

• Crooked nose straightened

• Dorsal hump smoothly reduced

• Drooping nasal tip appropriately corrected

• Maxillary protrusion naturally refined via nasolabial angle correction

• A natural and well-balanced overall nasal appearance achieved

This case required resolving functional and cosmetic issues at the same time.

Importance of septal reconstruction

When the septum is severely deviated, simply altering the external appearance cannot provide a fundamental solution. The septum must be reconstructed to resolve nasal obstruction and properly straighten a crooked nose. Using autologous rib cartilage maintains a stable structure over a lifetime without concerns of absorption or deformation.

Nasolabial angle overcorrection and the recovery process

Following nasolabial angle correction to improve maxillary protrusion, the nasolabial angle may appear overcorrected for about 3 to 6 months after surgery, causing the upper lip to feel slightly pulled. This can create a sensation of requiring slight effort to close the mouth, but it is part of the natural recovery process. As time passes and the tissues soften and settle, this resolves naturally.

Harmony of function and aesthetics

In rhinoplasty, functional aspects are just as essential as aesthetic improvements. When nasal obstruction and external concerns are resolved together, as in this case, the patient's quality of life improves significantly. Breathing becomes easier while self-confidence is enhanced. NOSELAB will continue to provide customized surgical plans that carefully account for both function and aesthetics.

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

#closedrhinoplasty #closedrevisionrhinoplasty #septalreconstruction #autologousribcartilage #crookednosecorrection #dorsalhumpcorrection #nasolabialanglecorrection #nasalobstructionrelief #functionalrhinoplasty