Rhinoplasty for symmetrizing a very asymmetrical nose

Rhinoplasty for symmetrizing a very asymmetrical nose, by Dr. Gerbault:

One of the biggest challenges in rhinoplasty is to make the nose more symmetrical when there is a significant asymmetry.
It is essential to analyze all the causes of asymmetry to try to correct them as best as possible.
In this case there is an asymmetry of the face that can be reduced by bone reshaping with ultrasonic rhinoplasty and cartilage reshaping with structural rhinoplasty.
In addition, there is a septal deviation that can be corrected by ultrasonic septoplasty.
Three months later, even if the nose is still a little swollen, the nose is visibly straighter and refined with a hump that has disappeared.

Asymmetrical nose with deviated nasal septum

Rhinoplasty on asymmetrical nose with deviated nasal septum, by Dr. Gerbault:

Deviated noses are difficult to perfectly fix, as they are often related to facial asymmetries and nose asymmetries (septal deviation, cartilage and bone asymmetry). When those asymmetries are related to specific nose features, they are easier to correct.
This young girl had a mild facial asymmetry, but above all a high septal deviation towards the left, that was creating a hump more visible on one side (in this case more visible on the right oblique view).
She had an ultrasonic rhinoplasty and septoplasty in order to straighten her nose and to remove her hump with ultrasonic rhinosculpture: no bone has been blindly broken. Moreover, her tip has been refined with cartilaginous sutures and then secured with a buried support graft: the cartilage has been reshaped and not trimmed.
She’s shown at 6 days post-op, when the splint is removed, and then a little after 3 months. Her nose is straighter and her hump has been corrected; her nose is still progressively going to refine in the following months.

Too short nose, rounded nasal tip, slight bump, and septal deviation, by Dr. Gerbault:

Short noses are difficult cases to correct. In the case of primary rhinoplasties, they are frequently associated with a strong maxilla that “pushes” in a way the nose upward and forward.
In the present case, 3 other difficulties were present: an acneic and thick skin, a very round tip related to the high position of the tip cartilages, and a significant septal deviation.
The operation has been an ultrasonic rhinoplasty using multiple cartilaginous grafts to lower the tip and the alae, to reposition also the tip cartilages. Those grafts have been harvested on the septum while it has been straightened.
The result is shown at day 6 postop, with some swelling but no bruising, and at 3 months post-op. The nose will keep on getting refined in the following months.

Significantly twisted nose, by Dr. Gerbault:

Significantly twisted noses are challenges in rhinoplasty: they frequently combine a facial asymmetry and a significant septal deviation. They are real aesthetic issues, but also functional issues with a nasal obstruction at least on one side.
This lady had both issues and beneficiated from an ultrasonic rhinoplasty with an ultrasonic septoplasty to straighten the septum, stabilize it in a straight position, and fix the nasal asymmetries while refining the nose.
The result is shown at a little more than a year post-op with an improvement of the asymmetry, and the returnof a normal nasal breathing.