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Crooked nose cases: analyzing midline alignment of bridge and tip separately

Records of crooked (deviated) noses include cases where the entire nose appears shifted to one side, as well as cases where nostril and columellar asymmetry is prominent. In one primary rhinoplasty patient, a crooked nasal bridge, dorsal hump, deviated septum, and nasal obstruction were documented together, while in another patient, indentations caused by adhesions and columellar depression were also observed.

In revision cases, changes in previously placed materials must also be considered. One article addresses the partial resorption of artificial dermis on the nasal bridge, a deviation toward the right, and a sharp nasal tip. Rather than drawing conclusions solely from the midline in the front view, compare it with the profile and nostril views, alongside the examination and surgical findings described in the original text.

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Nasal reconstruction when almost no septum remains after two nose surgeries — Before-and-after comparison
Before-and-after comparison

Nasal reconstruction when almost no septum remains after two nose surgeries

This is a case of septal cartilage deficit, nasal bone asymmetry, and nasal obstruction remaining after two surgeries. Through a closed approach, autologous rib cartilage was used for septal reconstruction, along with nasolabial angle correction, nasal bone asymmetry correction, and radix adjustment.

Preoperative condition · Postoperative record

Why noses deviate and bulbous tips persist after double jaw surgery, and how rib cartilage septal reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why noses deviate and bulbous tips persist after double jaw surgery, and how rib cartilage septal reconstruction is performed

This is a case of septal damage, a deviated nasal bridge, a bulbous nose, and nasal obstruction following double jaw surgery and two prior rhinoplasties. Autologous rib cartilage septal reconstruction, cartilage repositioning, lateral osteotomy, and functional nasal surgery were performed.

Preoperative condition · Postoperative record

Why the nasal tip can look bulbous and crooked after rhinoplasty with ear cartilage — Before-and-after comparison
Before-and-after comparison

Why the nasal tip can look bulbous and crooked after rhinoplasty with ear cartilage

This is a revision rhinoplasty case where the patient experienced a drooping tip, a deviated septum, and nasal obstruction after previous surgery. The septum was reconstructed using autologous rib cartilage, and silicone implant replacement along with rhinitis surgery was performed using a closed approach.

Preoperative condition · Postoperative record

Why rib cartilage reconstruction is needed when the septum is weak, even in primary rhinoplasty — Before-and-after comparison
Before-and-after comparison

Why rib cartilage reconstruction is needed when the septum is weak, even in primary rhinoplasty

A case of correcting a short, upturned nasal tip and a pinched nostril caused by congenital septal cartilage weakness. Autologous rib cartilage was used to reconstruct the septum and lower lateral cartilage, combined with lowering the nostril rim and lateral osteotomy.

Preoperative condition

Why a operated nose deviates and nostrils become asymmetric after physical trauma, and how septal reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why a operated nose deviates and nostrils become asymmetric after physical trauma, and how septal reconstruction is performed

A case where post-surgical trauma caused a septal tear, resulting in a crooked nose and nostril asymmetry. Septal reconstruction was performed using autologous rib cartilage, along with realigning the columellar central axis and replacing the implant.

Preoperative condition · Postoperative record

Why the nasal tip elongates and droops years after rhinoplasty, and how to correct it — Before-and-after comparison
Before-and-after comparison

Why the nasal tip elongates and droops years after rhinoplasty, and how to correct it

A case involving a long, drooping nasal tip and nasal obstruction following previous rhinoplasty with a silicone implant and septal cartilage. The nasal tip was corrected using autologous rib cartilage, performed concurrently with septoplasty, inferior turbinate reduction, and synechia adhesiolysis.

Preoperative condition

Why a nose operated on twice looks long and drooping, and how septal reconstruction using rib cartilage is performed — Before-and-after comparison
Before-and-after comparison

Why a nose operated on twice looks long and drooping, and how septal reconstruction using rib cartilage is performed

A revision rhinoplasty case where the septum was depleted due to excessive cartilage use in prior surgeries. The septum was reconstructed using autologous rib cartilage, a cartilage fragment on the bridge was removed, and silicone implant replacement was combined with osteotomy.

Preoperative condition · Postoperative record

Why a short, upturned nose makes the philtrum look long and septal extension graft — Before-and-after comparison
Before-and-after comparison

Why a short, upturned nose makes the philtrum look long and septal extension graft

We extended the septum with autologous rib cartilage and corrected the nasolabial angle to improve an upturned nasal tip and a long philtrum. Lateral osteotomy, a custom silicone implant, and rhinitis surgery were performed concurrently.

Preoperative condition · Postoperative record

Changes that occur when an implant is positioned high and deviated: methods for replacement and bulbous tip correction — Before-and-after comparison
Before-and-after comparison

Changes that occur when an implant is positioned high and deviated: methods for replacement and bulbous tip correction

A high, deviated silicone implant was replaced to lower the radix, and septal extension was performed using donor rib cartilage. Partial soft tissue resection, cartilage tie, and rhinitis surgery addressed the bulbous tip and nasal obstruction.

Preoperative condition · Postoperative record

Why a nose looks more crooked with facial asymmetry and how to correct it — Before-and-after comparison
Before-and-after comparison

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

Residual facial asymmetry and a deviated septum following double jaw surgery were corrected using autologous rib cartilage reconstruction. Lateral osteotomy, precision carving of a silicone implant, and rhinitis surgery were performed concurrently.

Preoperative condition · Postoperative record

Why the nasal tip deviates to one side after rhinoplasty and methods for reconstructing its support structure — Before-and-after comparison
Before-and-after comparison

Why the nasal tip deviates to one side after rhinoplasty and methods for reconstructing its support structure

Septal cartilage damaged from previous surgeries was reconstructed using autologous rib cartilage, and the lower lateral cartilages were restored. Lateral osteotomy and rhinitis surgery were performed concurrently to correct the crooked nose and nostril asymmetry.

Preoperative condition · Postoperative record

Why implants show through and nostrils look M-shaped, and how to reconstruct them — Before-and-after comparison
Before-and-after comparison

Why implants show through and nostrils look M-shaped, and how to reconstruct them

Implant show-through at the nasal tip and thinned skin were reinforced with donor dermis, and foreign substances were removed. The nasal tip was reconstructed using autologous rib cartilage, along with dragon nose correction and lateral osteotomy.

Preoperative condition · Postoperative record

Why contracture remains in multiply operated noses: Reconstructing the columella and support framework — Before-and-after comparison
Before-and-after comparison

Why contracture remains in multiply operated noses: Reconstructing the columella and support framework

Contracture and septal defect resulting from repeated surgeries were reconstructed using autologous rib cartilage. For the retracted columella, retroauricular free skin flap grafting and perichondrium grafting were performed to restore its shape.

Preoperative condition · Postoperative record

Why nostrils become asymmetrical and the nose looks crooked, and how rib cartilage reconstruction is performed — Before-and-after comparison
Before-and-after comparison

Why nostrils become asymmetrical and the nose looks crooked, and how rib cartilage reconstruction is performed

Nostril asymmetry caused by a tilted columellar axis and loss of alar cartilage after Gore-Tex insertion was corrected through Gore-Tex removal, autologous rib cartilage alar reconstruction, and septoplasty.

Preoperative condition · Postoperative record

Why a multiply operated nose deviates and develops a widened tip, and how cartilage is reconstructed — Before-and-after comparison
Before-and-after comparison

Why a multiply operated nose deviates and develops a widened tip, and how cartilage is reconstructed

Following three prior procedures, a deviated nose caused by septal damage and a missing right lower lateral cartilage was restored through autologous rib cartilage structural reconstruction, silicone implant replacement, nasolabial angle correction, and rhinitis surgery.

Preoperative condition · Postoperative record

Why the nasal tip can remain upturned after revision rhinoplasty, and when donor rib cartilage is used — Before-and-after comparison
Before-and-after comparison

Why the nasal tip can remain upturned after revision rhinoplasty, and when donor rib cartilage is used

An upturned and deviated nose, accompanied by hesitation toward autologous rib cartilage due to past pneumothorax, was improved without implants using donor rib cartilage, recycled previous rib cartilage, nasal bone rasping, and nasolabial angle correction.

Preoperative condition · Postoperative record

Why a nose looks bulbous or pug-like, and how to refine both the nasal tip cartilage and nasal bones together — Before-and-after comparison
Before-and-after comparison

Why a nose looks bulbous or pug-like, and how to refine both the nasal tip cartilage and nasal bones together

A blunt, pug-like nose, retracted columella, and wide nasal bridge were transformed into a slim, three-dimensional profile using autologous rib cartilage tip plasty, columellar lowering, lateral osteotomy, and cartilage reduction with suturing.

Preoperative condition

Why nostril asymmetry worsens with repeated revisions, and how to correct the columella — Before-and-after comparison
Before-and-after comparison

Why nostril asymmetry worsens with repeated revisions, and how to correct the columella

After 6 previous surgeries, a drooping and tilted columella, crooked nose, and nostril asymmetry were stabilized through a closed approach using autologous rib cartilage reinforcement, lateral osteotomy, and columellar alignment correction.

Previous surgeries and procedures · Preoperative condition · Postoperative record

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Common questions before reading the cases

Are an externally crooked nose and a deviated septum recorded as the same condition?

This website classifies the two into separate topics. In one case, both a crooked nasal bridge on the front view and nasal obstruction caused by a deviated septum were noted, linking it to both topics. However, a description stating that the nose appears deviated in photographs does not replace the assessment of the internal septal condition. Please check both the external cosmetic findings and the examination findings separately in each post.

Why are nostril photos compared in crooked (deviated) nose cases?

One case record notes overall deviation of the nasal bridge along with nostril asymmetry, columellar depression, and pinching of one nostril. The nostril view also separately documents the size of both sides and scars from previous surgeries. This allows the deviation visible from the front view to be evaluated alongside the condition of the nasal tip and nasal base, helping to differentiate nuances even within cases of a crooked nose.

Related topics to explore

Deviated septumNostril asymmetryOsteotomy and nasal bone correctionImplant displacement and deviation

Surgical records referenced in this guide

  • Why a crooked nose and dorsal hump appear together, and how to approach male rhinoplasty
  • How to correct a crooked nose and nostril asymmetry together
  • Why donor dermis absorbs after multiple revision surgeries and how to reconstruct the septum
Original article

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