Crooked Nose Tip and Nasal Base

A Straighter, More Symmetrical Look in the New York Area

The crooked tip is slightly different than the category of a crooked nose. As mentioned on the crooked nose page, there are many causes, including fractured nasal bones, that result in a crooked, asymmetrical nose. When we refer to the crooked nose tip at our New York practice, we are typically referring to the lower two thirds of the nose, which is cartilaginous in nature. This typically involves the nasal septum as far as the nasal base and many of the primary support mechanisms for the nose. Many patients have difficulty breathing as well, since air flow in the lower aspect of the nose goes through the area of the nasal valves which, when poorly supported, result in collapse.

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Evaluation of the crooked nose tip and nasal base starts with a consultation with an experienced rhinoplasty and nasal reconstruction specialist. If a patient has a crooked nosetip and base, it is very likely that the nasal septum is involved, and most of the time a patient also has a deviated nasal septum in conjunction with poor support in the other major support mechanisms of the nose. Think of the septum as the center poles of a tent supporting the entire nose from top to bottom. A crooked nose tip is usually the result of either the septum being disfigured and/or the lower lateral cartilages being involved. An experienced rhinoplasty specialist should be able to give the patient some insight as to what is the primary culprit. To fix and address the problem of a crooked nose tip, an experienced surgeon will typically remove, cut,and subsequently rebuild the nose and lower lateral cartilages with cartilage obtained from the septum. Think of cutting out the bad pieces and recycling cartilage to rebuild the nose straighter, stronger, and more symmetrical.

Crooked Nose Tip and Nasal Base FAQs

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Where Are the Incisions in Crooked Nose Tip/Nasal Base Surgery?

Depending on the surgical preference of the surgeon, the incisions in crooked nose tip/nasal base surgery will vary. There are two basic approaches: the open approach or closed approach. The open approach is used by some surgeons who believe it offers more precision, as the area is more open to viewing. Unlike the open approach, with the closed (also known as endonasal or scarless) approach, the outside of the nose has no incisions.

As an experienced surgeon, Dr. Williams prefers the closed approach when correcting a crooked nose tip/nasal base, as it is virtually scarless, involves less healing time, and allows for more predictable outcomes. However, the closed approach also puts more rigorous demands on the surgeon, as it is a more complex surgery. For the first decade of his practice, Dr. Williams used the open approach, giving him valuable insight into the inner workings of the nose and the experience needed to now expertly and almost exclusively perform endonasal surgery.

The procedure is covered in depth on Dr. Williams’ Famous Fireside Chats series titled, The Great Debate: Open vs. Closed Rhinoplasty.

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Do You Pack the Nose after Crooked Nose Tip/Nasal Base Surgery?

Dr. Williams mainly uses the endonasal or scarless approach for most crooked nose tip/nasal base rhinoplasty procedures. As a result, he does not see the need for a heavy packing of the nose after surgery.

While some surgeons believe heavy packing holds the nose in position after this surgery, Dr. Williams has found this is unnecessary if the surgery is performed well in the first place. Instead, Dr. Williams uses only a limited amount of dressing in each nostril (about the thickness of a light tampon), which is removed 24 hours or so after surgery. This can be reassuring to patients who have heard that the packing is the most unpleasant part of a crooked nose tip/nasal base surgery.

Dr. Williams also advises patients to avoid any activity where the nose could be bumped for about two weeks after the outer splint is taken off (about one week after surgery).

To see how the nose is handled after surgery, check out Dr. Williams’ Famous Fireside Chats video on rhinoplasty.

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Will Crooked Nose Tip/Nasal Base Surgery Fix Breathing Problems?

Many crooked nose tip/nasal base patients have difficulty breathing due to a deviated nasal septum, narrowing of the valve area, or a twisted nose.

Patients undergoing crooked nose tip/nasal base surgery should be evaluated by an expert rhinoplasty surgeon to see if it can be addressed during surgery for cosmetic reasons.

Dr. Williams addresses more such questions on his Famous Fireside Chats on fixing breathing issues during a procedure.

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The Cost of Crooked Nose Tip/ Nasal Base Surgery

The cost of surgery correcting a crooked nose tip/nasal base is determined with several factors in mind, including whether this is the patient’s first such procedure or it’s a revision (second or third) procedure.

A second or third surgery is often more challenging, as it is more complicated and takes more time. A revision typically requires the services of a highly skilled surgeon whose fees reflect his or her extensive training and experience.

Also, while not entirely relevant to a surgeon’s skill, the practice’s geographic location can be a factor in cost, as surgeons operating in a major metropolitan area are likely to charge more for a crooked nose tip/nasal base surgery than surgeons operating elsewhere.

Finally, a surgeon’s fees for the procedure typically reflect his or her experience—which can make all the difference in achieving successful outcome in any procedure.

The cost of crooked nose tip/nasal base rhinoplasty ranges between $7,000 and $14,000, depending on operating room and anesthesia costs. Refer to Dr. Williams’ Famous Fireside Chats for more information on the cost of this and other surgeries.

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Contact Lenses or Glasses Following Crooked Tip/Nasal Base Surgery

It is often difficult to wear glasses after surgery to correct a crooked nose tip/nasal base, since most surgeons will place a splint or cast on the outside of the nose. The Williams Center encourages crooked nose tip/nasal base patients to affix a small piece of tape to the midsection of their glasses and suspend them from their forehead.

Contact lenses are typically not worn for a week or so once the splint is removed. After that, we allow crooked nose tip/nasal base patients to resume normal contact use.

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How is Computerized Imaging used in Crooked Nose Tip/Nasal Base Surgery?

The patient looking to correct a crooked nose tip/nasal base is digitally photographed. The doctor then modifies the resulting images and uses them in his conversations with the patient, showing what he sees and how he will work to toward an ideal surgical outcome.

Computerized imaging it a valuable communication tool when talking to patients about what can be done to fix a crooked nose tip/nasal base. For that reason, Dr. Williams has relied on such imaging for nearly three decades.

Dr. Williams’ book Rhinoplasty: Everything You Need to Know about Fixing and Reshaping Your Nose addresses additional questions regarding surgery correcting a crooked nose tip/nasal base and covers them in his Fireside Chats on rhinoplasty on our YouTube channel.

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Complications and Risks of Crooked Nose Tip/ Nasal Base Surgery

Reputable surgeons with extensive rhinoplasty experience will let the client know about any possible complications and/or risks in the procedure correcting a crooked nose tip/nasal base.

Complications from crooked nose tip/nasal base surgery are rare, especially with a rhinoplasty surgeon who is competent and highly qualified. However, as with any surgery, bleeding or infection can occur.

Approximately five to 10 percent of crooked nose tip/nasal base surgery patients ask for or need a revision or touch-up surgery. With a more experienced surgeon, the odds of this are much lower, and any follow-up surgery is usually minor and often performed in the surgeon’s office.

Crooked nose tip/nasal base surgery is not a precise procedure. Surgeons must integrate all their experience, as well as their knowledge of anatomic variances in each patient.

To maximize approval of an outcome, the patient and surgeon should have a thorough and detailed consultation about their crooked nose tip/nasal base surgery. The patient should learn what to expect: what can and can’t be achieved in the crooked nose tip/nasal base surgery.

Questions about crooked nose tip/nasal base surgery are answered in Dr. Williams’ Famous Fireside Chats regarding complications following rhinoplasty.

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Anesthesia in Crooked Nose Tip/Nasal Base Surgery

Local anesthesia is typically used in crooked nose tip/nasal base surgery and, depending on the patient’s and doctor’s preference, twilight or general anesthesia may also be used. Many crooked nose tip/nasal base patients choose not to be awake, and surgeons often find this preferable for their patients. All anesthesia options are administered by credentialed providers and allow the patient to return home after the procedure.

Crooked nose tip/nasal base surgery is further explained in Dr. Williams’ Famous Fireside Chat on anesthesia for rhinoplasty.

If you’re considering a cosmetic procedure to straighten a crooked nose tip and nasal base and want to consult with an experienced New York-area facial plastic surgeon, call the Williams Center at 1-800-742-2797 today!

To request a consultation in the New York area, contact the Williams Center for Plastic Surgery online or by phone at 1-800-742-2797.

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