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- A deviated or crooked nasal septum is the most commonly crooked part of the nose that may cause the whole nose to deviate to one side or another. The septum is a bony and cartilage wall normally in the midline between the nostrils going all the way back to your pharynx. Because it is thin, flat, and goes all the way to the top and to the front of the nose, any nasal trauma can bend it, fracture it, or move it to one side or the other. If the septum becomes crooked, the entire nose may appear crooked. Usually, surgical septoplasty by a skilled operator can straighten it. Sometimes, injectable filler or minor office procedures can improve septal deviation significantly.
- Nasal bone structure shapes the upper one third to one half of the nose. If the nasal bones are asymmetric (right and left are differently situated) the nose appears crooked. Most often this is the result of injury and a broken nose, but may be a situation of birth or during youthful or adolescent bony growth and development. Rhinoplasty with osteotomies required to straighten a nose crooked from nasal bone asymmetry
- Tip cartilages (lower lateral cartilages) shape the nostrils and determine appearance of the nasal tip. If the right and left lower lateral cartilages are different size, shape, or angulation, the nose appears crooked and the tip may point off to the left or right. This may result from trauma, from previous surgery, or from birth, especially if cleft lip and/or cleft palate were present at birth. This situation may be improved by tip rhinoplasty, rhinoplasty, or if not severe, injection of filler or minor office procedures to adjust nostril shape and/or size.
- Skin and/or scars may cause the nose to appear crooked. Injuries or surgery involving cheeks, nose, upper lip, or adjacent areas may pull the nose to one side or the other, or higher or lower on one side causing a crooked appearance. Repair and/or improvement of skin problems causing a crooked nose is the domain of a skilled plastic surgeon, and most often an office procedure.
