Saddle nose is a condition that makes the nose appear like a saddle from the side. The middle portion of the nasal bridge looks like it has a dip, giving the nose an unnatural appearance. This happens because the nasal septum gets weak, causing it to dip. Saddle noses can be caused because of many conditions. The main causes of saddle nose include:
- Congenital deformities: These occur because of improper foetal growth during the early months of the pregnancy or it can be because of external factors during childbirth.
- Genetic factors: a missing nose, small nose or mushroom nose or a big nose can also cause saddle like appearance of the nose.
- Drug abuse: one of the main causes of saddle noses in adults is cocaine addiction
- Venereal diseases can pass this effect from the mother to the child
- Leprosy can lead to the saddle noses
- Previous nose surgery can weaken the septum and damage the bones causing it to collapse and dip
- Traffic accidents professional fights that cause the fracture of the bone in the nose
- Wegener’s granulomatosis
- Congenital syphilis
Saddles noses have two types of classifications, one is according to the severity and one is according to the type of the dip. According to the severity saddle noses are classified as
- Mild saddle, in which the nasal collapse is mild and the nasal dorsum is wide and flattened
- Moderate saddle, where the collapse is quite apparent and the nasal tip is flat and the nose appears shorter
- Severe saddle gives a depressed nasal dorsum and the deformity is quite obvious.
Saddle noses can also be:
- Involving only the nasal bridge. This occurs when the bridge cartilage has collapsed and the overlying tissues sink inwards. In cases of old injuries, the bones can also get depressed.
- Involving the nasal tip along with the bridge. Along with the nasal bone, cartilage and the septum, the damage can be severe enough due to the scarring, to affect the tip of the nose. This can cause the nose to rotate up, which appears unnatural. This kind of deformity gives the nose a pig nose kind of appearance.
Complex Rhinoplasty for Saddle Nose deformity
Correcting the saddle nose is a complex Rhinoplasty procedure and requires great expertise. A knowledge and practice on advanced Rhinoplasty techniques is needed for successful complex rhinoplasty. In order to provide and restore support to the nasal bridge to correct saddle nose deformity, the nasal bone and the bridge cartilage have to be reconstructed in a proper manner. In most of the cases, it becomes necessary that something is added to the nose to give it the support and shape and that something is cartilage grafting. In cases where the cartilage is already weak because of previous surgery then the cartilage can be taken from the ear for grafting purposes for a successful result.
In the complex rhinoplasty surgery, the cartilage is carefully shaped and placed above the depression so that the bridge height can be restored. This is also referred to as dorsal augmentation.
For patients who also surfer from a nasal tip rotation along with the nasal bridge dip the cartilage harvesting has to be extensive and the graft is taken from the septum as well as the ear. A longer graft is used to correct this type of deformity. Since this is a complex Rhinoplasty, the nasal tip is also reconstructed to restore the length of the nose and rib grafting is used to give the strength and support to the bridge so that it stays for a long time.
There might be some cases in which the cartilage from the nose or ear is not enough to correct the saddle deformity and therefore rib cartilage or biocompatible materials can be used successfully.
Proper after care post the surgery is needed by the patient to ensure best results. Therefore it is important to keep the nose away from any strain for at least five weeks post the surgery. In that period the redness and swelling will go down and slowly you can return to all your daily activities.