Surgery of the crooked nose.

A deviated nose is typically asymmetric in essentially all components of bone, cartilage, mucosa, skin, subcutaneous tissue, and even in perichondrium thickness. Additional asymmetry can be present when persistent torsion has caused unequal resorption, replacement, growth, and proliferation of tissues. It is necessary to equalize the osteocartilaginous vaults, to bring septum, vomer crest, and maxillary spine to midline position, and to equalize upper and lower lateral cartilages, septal mucosa, and dorsal subcutaneous tissue; it is sometimes necessary to reposition nasal turbinates. To help prevent slight postrhinoplasty deviation toward the direction of preoperative deflections, minimal overcorrection of deformities may be appropriate in surgical trimmings, shaping, and positioning.