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THE SEVERELY TWISTED NOSE

LECTURE ON OSTEOTOMIES

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SPECIFIC COSMETIC REQUESTS

VI.C. The Broken Nose

After a nasal fracture, a patient's nose may be twisted to one side or the other. Also, the patient may have a new "bump"—this is called a "saddle nose" or "boxer's nose" deformity. A "before" and "after" example is shown in Figure 29.

$Rhinoplasty picture of patient with nasal fracture$

$Rhinoplasty picture after correction of nasal fracture$

FIGURE 29. The broken nose (a) preoperative, (b) postoperative.

VI.D. The Twisted Nose

The twisted nose is one of the more technically challenging problems in rhinoplasty, requiring an experienced and skillful rhinoplasty surgeon. In the hands of an experienced and skillful surgeon, significant improvement is usually possible (Fig. 30). Sometimes the nose can be made completely straight; however, the patient should expect some deviation to persist.

FIGURE 30. The twisted nose (a,b) preoperative, (c,d) postoperative..

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