Secondary rhinoplasty: revising the crooked nose

Overview

A crooked nose that persists or appears after an earlier operation is common and hard to fix. The author reviews the usual causes of a residual or new deviation after treatment and matches each cause with its surgical solution, distinguishing minor deformities from complex ones.

Sections of note

• Review article; the abstract gives no patient series, technique details or outcome figures.
• The crooked nose deformity is described as very common and difficult to correct.
• Minor deformity can be corrected with simple techniques.
• Complex cases frequently need more aggressive management.
• The article reviews common causes of crookedness after previous treatment and their solutions.

What it means for a patient

• A nose that is still crooked after surgery is a recognized problem with known causes, not an unusual failure.
• The fix ranges from a small adjustment to a full rebuild depending on what is wrong underneath.
• The abstract offers no success rates, so how often revision straightens the nose cannot be judged from it.

Why this paper matters

Deviation is among the leading reasons for revision rhinoplasty, and revising a previously operated crooked nose is harder because of scar and missing cartilage. This article organizes the causes and approaches for that setting. Comparative outcome data for the techniques are not presented.

Terms

• Secondary rhinoplasty: a repeat operation on a nose that has already had surgery; also called revision.
• Crooked nose deformity: a nose that deviates from the facial midline.
• Septum: the wall of cartilage and bone dividing the nose, often the source of deviation.
• Osteotomy: a controlled cut through nasal bone used to move the bones toward the midline.
• Iatrogenic: caused by previous medical or surgical treatment.