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Reconstructive Rhinoplasty (Deviated Nose Correction)

Reconstructive rhinoplasty is a specialised procedure designed to address both functional and aesthetic concerns caused by a deviated nose. The procedure aims to improve breathing, restore nasal symmetry, and harmonise the nose with the overall facial structure. By tailoring surgical techniques to the individual’s needs, reconstructive rhinoplasty offers a comprehensive solution for patients seeking enhanced function and appearance.

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Dr Terence Goh

MBBS

MMed

MRCS

FAMS

Deviated+Septum Deviated+Septum

Indications & Benefits

Reconstructive rhinoplasty addresses both physical and functional issues associated with a deviated nose.

  • Conditions Treated

    The procedure corrects issues such as a deviated nasal septum caused by congenital factors or injury. It also addresses external asymmetry associated with these deviations.

  • Functional Improvements

    Structural corrections enhance airflow, alleviating breathing difficulties and improving comfort during physical activities.

  • Cosmetic Enhancements

    By realigning the nasal structure, the procedure improves the appearance of the nose and its balance with other facial features, helping individuals achieve their desired look.

Ideal Candidates for Reconstructive Rhinoplasty

Reconstructive rhinoplasty is suited for individuals experiencing structural or functional issues with their nose. The procedure can address the following concerns:

  • Facial Asymmetry

    A crooked or deviated nose causing visible facial imbalance can be corrected to restore symmetry.

  • Nasal Injury

    Traumatic injuries resulting in a crooked nose can be addressed by realigning the nasal framework to its natural position.

  • Nasal Obstruction Without Severe Crookedness

    Internal deviations causing breathing difficulties can be resolved even if the nose appears straight externally.

  • Asymmetric Nostrils

    Uneven nostrils caused by cartilage or septal deviations can be corrected to improve both appearance and function.

  • Deviated Nose After Rhinoplasty

    Revision surgery can refine results and correct residual or new deviations following previous rhinoplasty.

What Causes Nasal Deviation?

Nasal deviation is caused by irregularities in the nose’s structural components, which include:

Deviated_nose_fracture

The nasal bones form the upper portion of the nose, known as the bony vault. Congenital irregularities or trauma, such as fractures, can cause deviation. Correction may involve camouflage techniques or osteotomy to realign the bones.

Deviated_nose_curved_tip

The lower portion of the nose is supported by upper and lower lateral cartilages, which shape and stabilise the tip. Misaligned cartilage can cause tip deviation, which can be corrected through reshaping or repositioning.

Deviated_nose_curved_septum

The septum divides the nasal cavity and nostrils into two halves. Deviation, weakness, or collapse of the septum can compromise both function and appearance. Correction typically involves repositioning or strengthening this structure.

Surgical Techniques

Camouflage Technique
Deviated Nose Correction

A minimally invasive method for mild deviations, this approach uses diced cartilage or dermal grafts to fill asymmetries, creating the appearance of a straight nose without altering underlying structures.

Septal Repositioning
Deviated Nose Correction

A dislocated or overly long septum is shortened and realigned onto the anterior nasal spine. Sutures secure the septum in place, creating a stable foundation for the nose tip.

Spreader Grafts
Deviated Nose Correction

Cartilage grafts, often taken from the septum or rib, are used to stabilise and straighten the septum, enhance airflow, and improve the dorsal profile.

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Preparing for the Procedure

Consultation

A detailed evaluation of the nose and facial proportions is conducted using imaging tools, such as 3D imaging or CT scans. This helps visualise potential outcomes and create a customised surgical plan.

Medical Evaluation

Health history, including previous surgeries and medications, is reviewed to identify any potential risks. Functional concerns, such as breathing issues, are also assessed.

Pre-Surgical Guidelines

Avoid blood-thinning medications, supplements, and smoking for at least two weeks before surgery to support healing. Imaging or medical tests may be recommended to refine the surgical approach.

Step-by-Step Procedure

1. Anaesthesia Administration

Most procedures are performed under IV sedation or general anaesthesia, ensuring patient comfort during the surgery. This is administered by an experienced anaesthetist, who monitors the patient throughout the surgery.

2. Surgical Techniques

An open or closed rhinoplasty approach may be used. Open rhinoplasty involves a small incision on the nasal columella, while closed rhinoplasty confines incisions to the nostrils. Both methods aim to access and reshape nasal structures.

3. Correction and Reconstruction

The surgical correction focuses on straightening the nasal septum, using methods such as septal repositioning for structural alignment, spreader grafts for reinforcement and airflow improvement, or the camouflage technique to address minor asymmetries. These adjustments aim to restore both function and aesthetic balance, tailored to the patient’s specific needs.

4. Closure and Dressing

Once adjustments are complete, the incisions are closed with sutures, and the nose is dressed with splints or bandages to support healing and maintain the new shape.

Post-Surgical Care and Recovery

Immediate Post-Surgery Care

Nasal packing, if used, is removed within 48 hours. Sutures, whether internal or external, are typically taken out after 5–7 days. Splints may be changed on the fifth day and are usually retained for up to 10 days to provide stability.

Swelling Management

Initial swelling begins to subside within 10–14 days, while more noticeable improvements occur within 1–2 months. It may take 6–12 months for the final results to become apparent as residual swelling gradually diminishes.

Recovery Process

Most patients can return to non-strenuous activities, including work, within 1–2 weeks. Strenuous activities, heavy lifting, or direct pressure on the nose should be avoided until full recovery allows for it.

Aftercare Recommendations

Patients should keep their head elevated during sleep, avoid sun exposure to minimise swelling and discolouration, and follow up regularly with their surgeon to monitor the healing process and address any concerns.

Key Factors for Successful Deviated Nose Correction

  • Addressing Functional Issues

    A comprehensive diagnosis is necessary to identify underlying breathing problems, such as septal deviation, which may not be immediately apparent. Correcting these issues ensures long-term improvement in nasal function and prevents recurrence of symptoms like congestion.

  • Reinforcing Nasal Structure

    Straightening the septum may weaken its structural support, requiring reinforcement to maintain stability. Strengthening techniques provide durability and help enhance airflow, ensuring the nose remains functional and aesthetically balanced.

  • Achieving Facial Harmony

    Successful outcomes depend on creating symmetry and proportion. Aesthetic planning incorporates facial angles and proportions, with 3D imaging tools aiding in visualising potential results. This approach ensures the nose complements the individual’s unique features.

Potential Risks and Complications

Reconstructive rhinoplasty may involve swelling, bruising, and temporary numbness, which typically resolve during recovery. Rare risks include infection, bleeding, scarring, asymmetry, or changes in sensation. Revision surgery may occasionally be needed to refine results or address unresolved concerns.

Frequently Asked Questions (FAQ)

How long does the procedure take?

Reconstructive rhinoplasty typically lasts between 1 and 1.5 hours. The exact duration depends on the complexity of the nasal deviation and the surgical techniques required, such as septal repositioning or the use of grafts.

How long do the results last?

The results are intended to be permanent, as the structural corrections are designed to endure over time. However, natural ageing, external trauma, or changes to the facial structure may gradually affect the nose’s appearance or function.

Can this surgery fix my snoring?

If snoring is caused by nasal obstruction or restricted airflow, reconstructive rhinoplasty can address these issues by straightening the nasal septum or using grafts to improve airflow. While it may not resolve snoring caused by other factors, such as throat issues, many patients experience relief following the procedure.

Will there be visible scars after surgery?

Scars are minimal and carefully placed. Open rhinoplasty involves a small incision on the columella (the tissue between the nostrils), which typically fades and becomes nearly invisible over time. Closed rhinoplasty confines incisions to the inside of the nostrils, resulting in no external scars.

How much pain should I expect during recovery?

Most patients experience mild to moderate pain during recovery, which is effectively managed with prescribed medications. Following post-operative instructions can help reduce pain and ensure a smoother recovery process.

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Dr Terence Goh

Choosing to combine the intricate skills of microsurgery with aesthetic surgery, Dr Goh specialises in gynaecomastia, surgery of the Asian face, particularly Asian eyelid surgery and rhinoplasty.

Blending the precision of microsurgery with the artistry of aesthetic surgery, Dr Goh has a special interest in gynaecomastia, facial procedures, including ptosis and eyelid surgery, as well as rhinoplasty.

He also offers a full range of body contouring procedures such as mummy makeovers, breast augmentation, liposuction, and body sculpting—designed to help patients feel more confident and comfortable in their own skin.

Beyond aesthetics, Dr Goh remains active in reconstructive microsurgery, with expertise in breast reconstruction, head and neck reconstruction, and lower limb salvage—restoring both form and function where it’s needed most.

  • Bachelor of Medicine, Bachelor of Surgery, National University of Singapore
  • Master of Medicine, National University of Singapore
  • Member of the Royal College of Surgeons
  • Fellow of the Academy of Medicine, Singapore (Plastic Surgery)
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