Since no two cases are exactly the same, each patient’s crooked nose surgery will involve a uniquely customized treatment plan designed to address the aesthetic and functional issues created by the nasal deformity. Dr. Sedgh may perform septoplasty, septorhinoplasty, nasal fracture repair, reconstructive rhinoplasty, or even a combination of various procedures, depending on the specific structural issues that are causing your crooked nose.
There are two approaches used in performing rhinoplasty: the closed approach and the open approach.
In the open approach, a small bridging incision is made across the partition separating the nostrils to allow the doctor to lift the skin and expose the underlying framework. Additional incisions may be made inside the nose if needed. It is usually used for more complex surgeries as it provides unencumbered visual access to the nasal structure.
The closed approach, on the other hand, only employs incisions made within the nostrils. It is best for simpler cases and offers certain benefits such as shorter recovery time and eliminated risk of visible scarring.
Upon making the necessary incisions, Dr. Sedgh will carefully make the necessary adjustments to repair the crookedness of the nasal structure. Typically, this involves an osteotomy to enable the mobilization of the deviated nasal bones. Using a medical grade chisel, the doctor will create controlled bone fractures before repositioning the bones into a straighter structure.
There are many other techniques designed to specifically address each type of deformity. The doctor may perform resection and replacement with a straight septal cartilage graft for a deformed caudal septum, or use a certain type of cartilage grafting, from various donor sites such as the rib or ear. Some of the common cartilage grafts used include spreader grafts to address internal nasal valve narrowing or collapse, alar batten or strut graft to address the lower nasal sidewalls and external valves, and finally, caudal septal extension graft, which is a more modern grafting technique with robust ability to bring changes to the lower third of the nose.
Once the surgery has been completed, Dr. Sedgh will close the incisions and install a splint to help support the newly formed nasal structure while it heals. This helps maintain the nose’s new shape and structure, thereby safeguarding the integrity of the final results.