The most common cause of nasal breathing problems is a deviated septum. In addition, excessive dilation of the turbinates, malfunctions in the nasal valve mechanisms, space-occupying masses such as polyps, and conditions like allergic rhinitis can also lead to breathing problems. Septal deviations that cause significant narrowing or create a crooked nasal appearance affecting the patient’s daily life must be corrected. Treatment for septal deviation is not, and should not be, a small fifteen to twenty-minute operation involving the removal of the deviated section. In the technique currently used, a limited portion of the septal cartilage is removed, and no correction is made to the remaining cartilage. This significantly disrupts the septum’s support mechanism, leading to functional impairment and further deviation.

Furthermore, cartilage fragments that might be necessary for a future rhinoplasty are sacrificed. Moreover, the septum is often deviated entirely; the deviation is not limited to a specific area. Therefore, since the remaining septum fragment will also remain curved, sufficient improvement in function may not be observed. This also does not correct the visible curvature in the nose. However, in the cartilage-sparing septum corrections we apply, more permanent and functional results can be obtained with cartilage scoring techniques, some special suture techniques, unilateral or bilateral support cartilages, and techniques such as repositioning the septum and re-suturing it to the midline of the nasal base. In this method, since the aim is to bring the septum as close as possible to its proper plane, we can also correct the outward curvature of the nose. However, a crooked nose is not caused solely by septum curvature; in other words, correcting septum curvature alone does not correct nasal curvature. The asymmetry observed in the nose when viewed from the front is often due to disharmony in all units of the nose.

The curvature is not limited to just one structure. Therefore, to correct the curvature, it is necessary to make the necessary changes in all structures where asymmetry is observed. For example, the nasal bones on the right and left are fractured at different levels, cartilage supports of varying thicknesses are placed where the upper cartilage pieces forming the nasal roof join the septum, and the amount of elevation, thinning, and narrowing of the cartilages forming the nasal wings varies between the right and left. The goal is to obtain a breathable nose where all the structures of the nose are in harmony with each other and as symmetrical as possible.