The nose sits at the very center of the face, serving as its "central axis" and playing a crucial role in facial aesthetics. What can be done if the nose is crooked? Below are detailed descriptions of two rhinoplasty techniques for correcting a deviated nose.
I. Cartilage Deviation Correction
Make curved incisions in the nasal vestibules on both sides of the nasal cavity, above the alar cartilages. Insert a bistouri blade along the anterior surface of the lateral nasal cartilage to dissect the soft tissues from the nasal framework up to the nasal bone. Take care not to damage the skin on the nasal dorsum.
II. Skeletal Deviation Correction
Skeletal deviations are complex, involving protrusions, depressions, and twists. This section focuses on nasal deviation caused by collapsed nasal bones due to untreated trauma. Correction methods for other deviations should be tailored to specific pathologies.
1. Position: Semi-recumbent position with skin disinfection.
2. Incision: Make an arc-shaped incision at the anterior vestibule on the concave side and above the alar cartilage. Insert small scissors or a double-edged blade through this incision to dissect the soft tissue overlying the nasal bone.
3. Sawing the Collapsed Nasal Bone: Use a nasal saw to saw through both sides of the collapsed nasal bone, allowing it to move freely. This step can also be performed with a nasal chisel.
4. Nasal bone repositioning: Use a retractor to lift the re-fractured nasal bone within the nasal cavity. Pack the cavity with chloroform gauze to prevent collapse.
Deviated noses can be classified into three types: ① Oblique Type: Also known as simple deviation, this type involves lateral displacement of the nasal cartilage (lower nasal region), sometimes accompanied by mild nasal bone deviation. Characterized by the middle-lower nasal bridge deviating toward one side of the midline, with the nasal tip point furthest from the midline. Primarily congenital or caused by childhood trauma.② C-shaped: Characterized by both the nasal root and tip remaining on the midline, while the middle nasal bridge curves away from the midline in a C-shape. ③ S-shaped: Also known as complex deviation, where both the cartilaginous and bony nasal structures deviate in opposite directions, forming an S-shaped curve.
Depending on the specific condition of the cartilaginous or bony structures, correction may involve either cartilage deviation correction alone or simultaneous correction of both bony and cartilaginous deviations.
Editor's Note: Deviated nose correction is classified as a Level II procedure with moderate technical difficulty. For surgical safety and optimal outcomes, patients must undergo the procedure at a reputable plastic surgery hospital.