Correcting a Crooked Nose: the Surgical Options and Costs

Deviated nasal bridge?

Hello Dr.
Lu, about a year ago I inquired about the issue of my crooked nasal bridge.
This was your response at that time: "Hello, I have a question.
My nose is crooked, which I believe is due to an injury I sustained in childhood.
Now, it appears that the upper half of my nasal bridge is straight, while the lower half near the tip is crooked.
Although it is not very noticeable, I would like to correct it.
May I ask how much this correction would cost? I prefer not to use artificial materials; is that possible? Will my nose become fragile after surgery, and will it change shape again after a few years? How long do I need to rest after the surgery? When can I go out?"
[Response] Doctor: Pingtung Hospital / Plastic Surgery / Dr.
Lu Dao-Kuan "More questions answered by this doctor." The crooked nose should be evaluated for any deviation of the nasal septum and whether there are old injuries to the nasal bones.
It is not always necessary to use fillers.
If fillers are required, autologous tissue can be chosen, although it may be more painful.
A proper preoperative assessment is necessary to understand the potential outcomes.

Recently, I have actively sought out doctors to resolve this issue.
I first consulted a plastic surgeon, but the surgeon indicated that I have a deviated septum and advised me to see an otolaryngologist for treatment before discussing cosmetic concerns.
I then visited an otolaryngologist who confirmed that I do have a deviated septum and asked if I experience nasal congestion or runny nose.
However, aside from slight nasal congestion, I do not have any other issues that significantly affect my daily life.
The otolaryngologist mentioned that the surgery for a deviated septum and the cosmetic surgery for correcting a crooked nasal bridge are two separate matters.
If I do not have any nasal disease concerns, I can directly consult a plastic surgeon for the cosmetic correction of my crooked nasal bridge, as my primary concern is the appearance of the crooked bridge.

I would like to ask, given my situation, do I need to resolve the deviated septum issue first before undergoing the cosmetic surgery for the crooked nasal bridge (as per the plastic surgeon's advice), or can I proceed directly with the cosmetic surgery (as per the otolaryngologist's advice)? There seems to be some contradiction between the two doctors (it feels a bit like passing the buck), so I am somewhat confused about which specialist to consult.
Dr.
Lu, what should I do? Also, is there a connection between a deviated septum and a crooked nasal bridge? Is it possible that correcting the deviated septum could resolve the issue of the crooked nasal bridge? Thank you for your response, doctor.

A Xin, 20~29 year old female. Ask Date: 2005/06/23

Dr. Lu Daokuan reply Plastic Surgery

If there is a curvature of the nasal septum, it is advisable to seek reconstruction from a plastic surgeon.
It is best to consult a plastic surgeon with expertise in craniofacial surgery.

Reply Date: 2005/06/23

More Info

When considering surgical options for correcting a crooked nose, it's essential to understand the underlying causes, the types of procedures available, and the associated costs. Based on your situation, it seems that you have a crooked nose due to a past injury, and you are also dealing with a deviated septum. Here’s a comprehensive overview of your options and considerations.

Understanding the Conditions
1. Deviated Septum: This condition occurs when the nasal septum, the cartilage and bone that divide the nasal cavity, is off-center or crooked. While it can lead to breathing difficulties, it can also affect the aesthetic appearance of the nose.

2. Crooked Nose: The aesthetic issue of a crooked nose can stem from various factors, including previous injuries, congenital deformities, or even the effects of aging.

Surgical Options
1. Septoplasty: If your deviated septum is contributing to your nasal obstruction or discomfort, a septoplasty may be recommended. This procedure straightens the septum, potentially improving airflow and alleviating any nasal congestion. Importantly, this surgery can also enhance the overall appearance of the nose, especially if the deviation is significant.

2. Rhinoplasty: This is the cosmetic procedure specifically aimed at correcting the shape and structure of the nose. If your primary concern is the aesthetic aspect of your crooked nose, rhinoplasty can be performed independently of septoplasty. However, if the septum is significantly deviated, addressing it first may provide a better foundation for the cosmetic changes.

3. Combined Procedures: In many cases, surgeons perform both septoplasty and rhinoplasty simultaneously. This approach can be beneficial as it addresses both functional and aesthetic concerns in one surgical session.

Costs
The cost of these procedures can vary widely based on several factors, including the surgeon's experience, the complexity of the surgery, and the geographical location of the practice. On average, you might expect:
- Septoplasty: Costs can range from $3,000 to $10,000, depending on whether it's performed in a hospital or an outpatient setting.

- Rhinoplasty: This can range from $5,000 to $15,000 or more, particularly if it involves significant reshaping or correction.

- Combined Procedures: If both surgeries are performed together, there may be some cost savings, but the total could still be in the range of $8,000 to $20,000.

Recovery and Risks
1. Recovery Time: Recovery from septoplasty typically takes about 1-2 weeks, while rhinoplasty may require a similar or slightly longer recovery period. During this time, you may experience swelling, bruising, and discomfort, which can be managed with medication.

2. Risks: As with any surgical procedure, there are risks involved, including infection, bleeding, and dissatisfaction with the aesthetic results. It's crucial to discuss these risks with your surgeon.

3. Long-term Stability: Concerns about the nose becoming "weaker" or changing shape over time are valid. While surgical techniques have improved significantly, the long-term outcome can depend on various factors, including the healing process and the individual's skin type and age.

Recommendations
Given the conflicting advice from the ENT and plastic surgeon, it may be beneficial to seek a consultation with a facial plastic surgeon who specializes in both functional and aesthetic nasal surgery. They can provide a comprehensive evaluation and help you understand whether addressing the deviated septum is necessary before proceeding with cosmetic surgery.

In summary, if your primary concern is the appearance of your nose and you do not have significant breathing issues, you may proceed directly to rhinoplasty. However, if the deviated septum is causing discomfort or breathing problems, addressing it first with a septoplasty may be the best approach. Always ensure that you choose a qualified surgeon with experience in both areas to achieve the best possible outcome.

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