Surgical Correction of the Crooked Nose: A Procedure Proposal.
- 1From the Plastic and Reconstructive Surgery Unit, Centre Hospitalier Universitaire Bichat Claude-Bernard, Paris, France.
- 2Multidisciplinary Department of Medical-Surgical and Dental Specialties, Plastic Surgery Unit, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy.
- 3Department of Medicine, Saint Camillus International University of Health and Medical Sciences, Rome, Italy.
Abstract
A crooked nose, resulting from the collapse of cartilaginous and/or bony support, often presents with depression of the nasal tip and middle third. This condition is frequently associated with septal deformities that impair breathing and cause damage to the upper lateral cartilages and bony framework. Traditional surgical techniques typically involve septal correction and the use of cartilage grafts to restore structure and projection, though such methods carry a risk of fibrosis and recurrent deformity. We present an alternative surgical approach that reconstructs the nasal pyramid without the use of tissue grafts, which begins with transcartilaginous and transfixion incisions, followed by a subperichondrial dissection extending beneath the cartilaginous vault. The upper lateral cartilages are separated from the septum, and fibrotic tissue on the concave surfaces is removed. A standard septoplasty using the Killian method straightens the septum. Scar tissue from contractures is released through complete subperichondrial dissection on the mucosal side and partial dissection on the cutaneous side. To support healing and preserve dorsal projection, radiographic film strips or sterile silicone bands are applied in a sandwich-like configuration and removed after 5 days; the external splint is removed after 10 days. This technique avoids grafts by relying on intrinsic nasal structural elements. In 70% of cases, satisfactory anatomical correction is achieved without further intervention, whereas 30% require minor refinements. Importantly, no postoperative respiratory impairment has been observed, underscoring the technique's effectiveness in both aesthetic and functional nasal reconstruction.
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BibTeX
@article{cannistra2026surgical,
title = {{Surgical Correction of the Crooked Nose: A Procedure Proposal.}},
author = {Claudio Cannistrà and Felice Moccia and Luciano Guerrieri and Marcello Molle and Domenico Tripodi and Mario Faenza},
journal = {Plastic and reconstructive surgery. Global open},
year = {2026},
month = oct,
doi = {10.1097/gox.0000000000008205},
url = {https://europepmc.org/article/MED/42903433},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Surgical Correction of the Crooked Nose: A Procedure Proposal.
AU - Claudio Cannistrà
AU - Felice Moccia
AU - Luciano Guerrieri
AU - Marcello Molle
AU - Domenico Tripodi
AU - Mario Faenza
PY - 2026
DA - 2026/10/19
JO - Plastic and reconstructive surgery. Global open
DO - 10.1097/gox.0000000000008205
UR - https://europepmc.org/article/MED/42903433
AB - A crooked nose, resulting from the collapse of cartilaginous and/or bony support, often presents with depression of the nasal tip and middle third. This condition is frequently associated with septal deformities that impair breathing and cause damage to the upper lateral cartilages and bony framework. Traditional surgical techniques typically involve septal correction and the use of cartilage grafts to restore structure and projection, though such methods carry a risk of fibrosis and recurrent deformity. We present an alternative surgical approach that reconstructs the nasal pyramid without the use of tissue grafts, which begins with transcartilaginous and transfixion incisions, followed by a subperichondrial dissection extending beneath the cartilaginous vault. The upper lateral cartilages are separated from the septum, and fibrotic tissue on the concave surfaces is removed. A standard septoplasty using the Killian method straightens the septum. Scar tissue from contractures is released through complete subperichondrial dissection on the mucosal side and partial dissection on the cutaneous side. To support healing and preserve dorsal projection, radiographic film strips or sterile silicone bands are applied in a sandwich-like configuration and removed after 5 days; the external splint is removed after 10 days. This technique avoids grafts by relying on intrinsic nasal structural elements. In 70% of cases, satisfactory anatomical correction is achieved without further intervention, whereas 30% require minor refinements. Importantly, no postoperative respiratory impairment has been observed, underscoring the technique's effectiveness in both aesthetic and functional nasal reconstruction.
SN - 2169-7574
ER -