What is a saddle nose deformity?

A depression or collapse of the nasal dorsum makes the nose look like a saddle in profile view. The severity of saddling can range from barely noticable to extreme. The saddle is the result of reduced cartilaginous support of the nasal septum and upper lateral cartilages. There are many causes of a saddle nose deformity such as nasal trauma, intranasal cocaine abuse, granulomatous auto-immune disease (e.g. GPA) and prior septoplasty or septorhinoplasty.

How can a saddle nose deformity be corrected?

External rhinoplasty approach: reinforcement of the L-strut (e.g. spreadergrafts, septal replacement, ethmoid bone battens, etc) followed by additional dorsal augmentation when indicated. My preferred grafting material is autologous rib cartilage, but alternatively homologous ribcartilage or ear cartilage might be indicated.
Treatment of the underlying cause is off course most important before even considering reconstructive nasal surgery.

Unless otherwise specified, these preoperative and postoperative photographs are illustrations of functional rhinoplasty procedures, meaning that the aesthetic outcome was a secondary goal of the surgery. Examples of aesthetic rhinoplasty procedures will soon become available.

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