Many noses are asymmetrical and when significantly asymmetrical, appear crooked. This might be the result of an accident or just the way the person was born. There are other facial asymmetries that often are not recognized until the case is carefully examined by a cosmetic surgeon. This would include the ears, the eyebrows, the eyes and the lips.
When considering cosmetic surgery it is very important to assess the nose and determine whether or not there is crookedness. Because, if there is crookedness now, unless proper care is taken by the surgeon it is possible that after the rhinoplasty, the nose could be even more crooked.
The clue to making the proper assessment will come from the internal examination of the nose. This is part of a proper preoperative examination where the surgeon examines the nasal passages to assess the question of a deviated septum, which is one of the more common causes of a crooked nose. It also allows him to view the turbinates and other internal structures which, while not contributing to crookedness, may be factors in nasal blockage which should not be attributed only to the deviated septum and other elements of crookedness.
If the surgeon has the broad training necessary to perform all aspects of rhinoplasty, cosmetic nasal surgery and reconstructive nasal surgery then the management of the crooked nose is generally successful.
No surgeon can predict 100% that there might not be some asymmetries or some residual crookedness of the nose, owing to the fact that the cartilage which is contributing to the crookedness may be impossible to perfectly straighten. Typically, in a high percentage of cases, the crookedness is improved so much that the patient is satisfied and the byproduct is improved breathing translating to not only better air flow, but less chance of sinus problems or snoring.