Structural rhinoplasty for the persistently twisted nose

Correction of a crooked nose after primary rhinoplasty is a not uncommon and often complex problem encountered by facial plastic surgeons. Adequate and lasting correction of the deformity requires a thorough assessment of the anatomy contributing to the deviation, as well as the application of robust techniques to correct the problem at each subsite, which is reviewed in this article. Finally, risk factors for failure and common pitfalls are discussed.