Severe septal deviations can be a challenge for rhinoplasty surgeons, as the septum is a crucial element of the nasal framework. Correcting septal deviations is necessary to achieve a straight nose. It is important to ensure that the septum is aligned with the midline and free from tension to promote proper healing of the external nasal pyramid.

Many rhinoplasty surgeons believe that closed surgical techniques, such as preservation rhinoplasty, can be ineffective in correcting crooked noses. However, in some cases, combining a correct septoplasty with dorsal preservation techniques can yield natural-looking results with a quick postoperative recovery time.

Septal deviations can be caused by various factors, including trauma, iatrogenic causes, and congenital factors. While most people have some degree of facial asymmetry, deviations of less than 3 to 4 mm are often imperceptible. However, it is essential to inform the patient of their facial asymmetry before surgery to ensure their satisfaction with the results.

A thorough analysis of each anatomical component of the nose is necessary for planning the surgery, including the triangular cartilages and alars, the septum, the osseous vault, the pyriform aperture dimensions, the nasal spine, the soft tissues, and the ligament. Correction of the septum is essential for surgical success, as major septal deviations are usually present, and the nasal bones also play a crucial role.

In conclusion, correcting septal deviations is essential to achieving successful rhinoplasty results. The combination of a correct septoplasty with dorsal preservation techniques can be a versatile approach to correcting them.