A Systematized Strategy in Corrective Rhinoplasty for the Asian Deviated Nose

Background: A deviated nose is a common deformity encountered in rhinoplasty. Over the past several decades, a variety of rhinoplasty techniques have been described focusing on the classification of bony and cartilaginous deviation. Nevertheless, corrective rhinoplasty is still a challenging procedure even for experienced surgeons because of the high recurrence rate of deviation. In attempt to reduce the recurrence rate, the author systematized the complex procedures by using a single technique regardless of the classification of a deviation. Materials and Methods: Forty patients who underwent corrective rhinoplasty between June 2009 and December 2014 were reviewed retrospectively. All the patients were operated using 4 main surgical procedures: anterior approach septal correction, unilateral osteotomy, and medialization of the deviated complex to the contralateral intact side, and dorsal augmentation with a dermofat graft. Assessment of improvement was based on photo standardization. The degree of nasal deviation, nasofrontal angle, tip projection-to-nasal length ratio, vertical line of the upper lip-to-tip projection ratio, and columellar-labial angle were measured. Results: Preoperative and postoperative anthropometric measurements revealed that the mean degree of deviation changed from 10.19 degrees to 3.43 degrees (P < 0.01), and the degree of nasofrontal angle changed from 131.55 degrees to 133.14 degrees (P < 0.01). All patients responded to both the preoperative and postoperative questionnaires. The questionnaires revealed a significant functional and cosmetic improvement from 36.84 degrees to 76.95 degrees and 39.45 degrees to 79.41 degrees, respectively (P < 0.0001). Conclusions: This systematized strategy to correct the Asian deviated nose provided reproducible and consistent results It also resulted in low recurrence rates and high postoperative satisfaction among patients.