The Crooked Nose and Major Septal Deviations in Dorsal Preservation.

The crooked nose deformity (CND) has a multifactorial origin. Trauma, previous surgery, septal deviation, and maxillary and nasal bone hypertrophy contribute to asymmetry. The crooked nose has been deemed one of the most difficult to repair of all nasal deformities. Dorsal preservation (DP) rhinoplasty techniques have evolved to correct the boney vault, high septal deviations, and boney hypertrophy while limiting cartilage usage. A paucity of literature exists detailing functional and aesthetic outcome measures for DP. Herein the author's approach to improve the CND utilizing different DP techniques including the modified subdorsal strip method, Z flap, and the modified Cottle technique is presented.