The patient with a crooked or deviated nose presents a special challenge in rhinoplasty. The deviation may be a result of previous trauma or just aberrant growth pattern.
These types of noses often have asymmetrical features, uneven amounts of bone or cartilage on either side, areas of collapse opposite areas of excess prominence. Often underappreciated is the amount of internal deviation which may also be present and if not also corrected will doom the aesthetic result to failure. The surgeon also must take into account the natural tendency of "cartilage memory" to return to it's original deviated position even after correction and take steps to counteract this.