The twisted nose is typically caused by trauma and less commonly due to genetic deformity. The “twist” in the nose can occur at the upper bony part of the nose, the middle cartilaginous part of the nose, the tip or any combination of the three. If the tip is twisted, it can cause the nostrils to be different shapes, and cause breathing obstruction. The deformed shape of a twisted nose can be distracting, pulling attention away from other facial features.
Mildly Twisted Nose – Filler injections like Restylane or Juvederm can be used in the concave areas of the twist to improve the shape of the nose for a straighter appearance.
Moderate to Severely Twisted Nose – Only surgical solutions are recommended for moderate to severe cases.
Mildly Twisted Nose Closed or open rhinoplasty can be used to straighten the bones and cartilage and eradicate the twist. Depending on where the twist occurs, surgery can include:
- Grafting of cartilage to camouflage the twist, creating a symmetrical nose.
- If the tip of the nose is twisted, the cartilage may be deconstructed and reconstructed using cartilage grafts to rebuild a straight tip.
- When the twist is due to the nasal bones shifting in one direction, osteotomy can be performed to straighten the bone structure. This involves asymmetrical repositioning of the bones to move them into a straighter configuration.
Moderate to Severely Twisted Nose – An open approach rhinoplasty is necessary to permanently reshape the nose. The procedure can include:
- Osteotomy or cutting and re-positioning of the nasal bones, to straighten the upper bridge of the nose.
- Spreader grafts, sourced from a septum, are or rib, to add width to the middle vault of the nose.
- Nasal tip cartilages may need to be replaced or augmented with cartilage grafts to alter the shape and/or configuration of the tip of the nose.
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