eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Cosmetic Surgery

Rhinoplasty, Crooked Nose: Follow-up

Author: Steven H Dayan, MD, Clinical Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, University of Illinois
Coauthor(s): Anil R Shah, MD, Plastic Surgeon, Private Practice; Shefali I Shah, MD, Staff Physician, Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago
Contributor Information and Disclosures

Updated: Mar 18, 2009

Outcome and Prognosis

Surgical management of the crooked nose is deceivingly complex. Symptoms of nasal obstruction are common.

Nasal valve collapse, the degree of septal deformity, and tip status will help guide the surgeon to the appropriate approach for effective improvement.

Properly diagnosing deviating forces and treating them accordingly is imperative. Direct attention to the upper-third region as well as the lower two thirds of the nose.

Whether camouflaging techniques and/or structural reorientation are used, the rhinoplasty surgeon needs to be well versed in the different methods and philosophies of managing the crooked nose.

Future and Controversies

The future of crooked nose surgery may lie in future implant materials that are universally tolerated and not rejected. Obviously, this currently remains theoretical.

In 2006, Gurlek et al reported their experience with custom-made high-density porous polyethylene extended spreader grafts.1 Twenty patients had acceptable surgical results without extrusion. Mendelsohn described similar results with 40 patients.2 Further studies are necessary to determine the efficacy and reliability of implantable materials.

Some authors have noticed short-term success with biodegradable polymers, such as polylactides, which have stability for at least 7 months. The main limitation with the use of these polymers is that they may extrude and cause infection.3

Genetically created cartilage from tissue banks may someday represent a viable alternative to autogenous harvested cartilage, without the donor site morbidity and time required for harvest.

 


More on Rhinoplasty, Crooked Nose

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Follow-up: Rhinoplasty, Crooked Nose
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References
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References

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Further Reading

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Keywords

crooked nose, rhinoplasty, nose job, asymmetric nose, twisted nose, deviated nose, post-traumatic nasal deformity, crooked nose, deviated septum, nasal trauma, broken nose, external nasal deformity, nasal septal deviation, nasal fracture, fractured septum, crooked dorsum, deviated dorsum

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Contributor Information and Disclosures

Author

Steven H Dayan, MD, Clinical Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, University of Illinois
Disclosure: Nothing to disclose.

Coauthor(s)

Anil R Shah, MD, Plastic Surgeon, Private Practice
Anil R Shah, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, and Triological Society
Disclosure: Nothing to disclose.

Shefali I Shah, MD, Staff Physician, Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago
Shefali I Shah, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery and American Academy of Otolaryngology-Head and Neck Surgery
Disclosure: Nothing to disclose.

Medical Editor

Paul S Nassif, MD, FACS, Consulting Surgeon, Facial Plastic and Reconstructive Surgery, Spalding Drive Cosmetic Surgery and Dermatology
Paul S Nassif, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and California Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Dean Toriumi, MD, Department of Otolaryngology, Associate Professor, University of Illinois Medical Center
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown

 
 
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