Deviate nose is often associated with chin deviation. If the nose is deviated to the opposite direction as the chin is deviated, centering the nose in the midline makes the face less asymmetric. On the other hand, when the nose is deviated to the same direction as the chin is deviated, correcting the nose can make the face more asymmetric. In this case, the chin needs to be centered after rhinoplasty. Correcting the deviated nose not only makes a straight, well-breathing nose but also can make the asymmetric face more harmonious.
This lady in below photos had nasal deviation, hump nose, and tip ptosis with breathing difficulty. Septum was corrected first, and this made the lower 2/3 of the nose straight. Hump was not resected but rasped with Piezotome and this did not breach the keystone area, which made spreader grafts unnecessary.Bilateral osteotomies with Piezotome made her bone straight. Together with septum correction and effective osteotomies, her nose became straight from the frontal view. Tip was modified with sutures and onlay graft only. No strut or septal extension graft was used and this made the tip soft even after considerable amount of rotation and projection increase. Radix was augmented with bruised cartilage. Overall, she could breath much better after surgery and her nose became more harmonious and feminine.
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