Why is it difficult to fix a crooked nose?

Question:

I have a very crooked nose that I would like to have fixed. I’ve heard that it can be made straighter but that correcting a crooked appearance is very difficult and that I cannot expect it to be perfectly straight. Why is this?

Answer:

A crooked nose is one of the most difficult issues to correct in rhinoplasty surgery. Usually, there are both bony and cartilaginous issues to the crooked nose. Crooked bone may require multiple fractures to the nasal bones in order to get the upper part of the nose straightened, and this makes the nose somewhat unstable for a period of time. When the lower cartilaginous portion of the nose is crooked there are several rhinoplasty steps that need to be performed in order to straighten and sculpt that cartilage. I use several different rhinoplasty techniques to include spreader grafts, batten grafts, and onlay grafts. However, in spite of all of these rhinoplasty maneuvers and the pre surgical knowledge of the extent of the crooked cartilage, cartilage has some inherent memory and will not always stay in the newly straightened position. I am always able to significantly straighten a crooked nose, however, getting a crooked nose perfectly straight in rhinoplasty is not always possible.

Posted by Dr. Philip Schoenfeld