Why a nose looks more crooked with facial asymmetry and how to correct it

Hello, I am Dr. Peter C. Kang.

Today, I would like to introduce the case of a patient whose nose appeared severely crooked due to facial asymmetry, accompanied by bilateral nasal obstruction.

The patient had undergone double jaw surgery in 2019 to correct severe facial asymmetry. Even after the surgery, some facial asymmetry remained, creating a strong visual impression that made the nose appear more crooked. Consequently, the patient wanted both nasal contour correction and improvement of breathing issues.

• Correction of the crooked nose into a natural, straight bridge line

• Improvement of bulbous nasal tip

• Refining the profile line through nasolabial angle correction

• Relief of bilateral nasal obstruction

CT scan findings confirmed a severe deviated septum to the left along with rhinitis. Therefore, I established a comprehensive surgical plan to address both aesthetic correction and functional improvement simultaneously.

1. Septal reconstruction using autologous rib cartilage

• Harvesting the patient's own rib cartilage to reconstruct the deviated septum

• Securing a stable internal nasal support structure

2. Septoplasty

• Straightening the septum that had deviated to the left

• Root cause of nasal obstruction addressed

3. Bilateral rhinitis surgery

• Concurrent improvement of chronic nasal obstruction and rhinitis symptoms

• Creating an environment for comfortable nasal breathing

4. Lateral nasal bone osteotomy

• Shifting the nasal bones, which were displaced to the left due to facial asymmetry, toward the right

• Aligning the nose with the facial midline

5. Precision carving and insertion of a silicone implant

• Precisely carving the implant to match the patient's nasal bone contours

• Shifting the nasal bridge slightly to the right of center to naturally compensate for the visual curvature caused by facial asymmetry

Front view changes:

• Nasal bridge, previously displaced to the left, aligned with the center of the face

• Improvement in visual crookedness caused by facial asymmetry

• A refined nasal tip contour established

Profile view changes:

• Creation of a natural straight bridge line

• A smoother profile line achieved through nasolabial angle correction

• A balanced nasal line from the profile view

Nostril and functional changes:

• Symmetrically balanced nostril shape

• Improved breathing with relief of bilateral nasal obstruction

• Alleviation of rhinitis symptoms

Correcting a crooked nose accompanied by facial asymmetry requires a far more meticulous approach than standard rhinoplasty. When asymmetry of the facial structure itself remains, merely straightening the nasal bones can still leave the nose appearing visually crooked.

In this case, the surgical plan addressed a complex combination of issues: a left-sided deviated septum, chronic rhinitis, and facial asymmetry. Septal reconstruction using autologous rib cartilage secured structural support inside the nose, while lateral osteotomy and precision carving of the implant naturally compensated for visual asymmetry.

A deviated septum and rhinitis are functional issues directly affecting breathing rather than simple cosmetic concerns; resolving them alongside rhinoplasty significantly impacts the patient's quality of life.

I always strive to enhance patient satisfaction through customized surgery that addresses both the appearance and the function of the nose.

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

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