Nasal and septal deviation is functionally more bothersome than just having a bent looking or a crooked nose. Septal deviation can result in significant nasal airway obstruction and difficulty with nasal breathing.
People are either born with a deviated septum or develop it due to traumatic nasal fracture or as a result of complication of rhinoplasty. Nasal septum is a cartilage and boney wall that separates the two sides of the nasal airway. It functions like a support “pole which holds up a tent”, which is holding up the tip and the bridge of the nose. Nasal septum can break, bend, or lose its rigidity and strength by either trauma or due to rhinoplasty complication– over resection of the septum during septoplasty and rhinoplasty. This can not only cause the collapse of the nasal framework but can also result in devastating blockage of the nasal airway.
The primary approach for the repair of a crooked nose is to redo the nasal osteotomy, or to “re-break the nose”. This time the nasal bone is reset in a straight fashion and is casted with a straight nasal splint. This is also the primary approach for the repair of nasal fracture. If septal deviation also exists, then the crooked or bent portion of the septum is removed which is called a Septoplasty. During a septoplasty an incision is made internally on one side of the nasal septum. After the mucosal membrane is lifted away from the septal cartilage the deviated portion of the cartilage and/or bone is removed, therefore, re-straightening the nasal septum and to relieve nasal airway obstruction.
During Revision Rhinoplasty in Beverly Hills the crooked nasal bridge and septum can be straightened, reinforced with cartilage graft, and brought back into midline in order to make the nose straight and to keep the nasal airway open. A variety of nasal cartilage grafts are used such as the spreader graft, strut graft, and banner grafts. A spreader graft is a pair of straight pieces of cartilage which are sutured on each side of the nasal septum to reinforce and to keep straight the nasal septum and the nasal bridge. A spreader graft will not only straighten the nose but will also open a narrow internal nasal valve, which will in effect open up the nasal airway. A spreader graft rhinoplasty is performed either via an open rhinoplasty or closed rhinoplasty approach.