OBJECTIVE: To present a double lateral osteotomy technique for the correction of a crooked nose. A crooked nose has been recognized as one of the most difficult of persistent deformities to treat. The correction of functional and aesthetic problems resulting from this deformity presents a major challenge. A crooked nose is also known as a deviated, twisted, deflected, asymmetric, or scoliotic nose, and several types of osteotomies are employed for nasal correction. A single lateral osteotomy can be employed in most rhinoplasties, but in some cases such as with a crooked nose, other osteotomies have to be performed to obtain a good aesthetic and functional result. In these cases, a second osteotomy, the double lateral osteotomy, is conducted in a more lateral position than the standard procedure, and is necessary for the correction of nasal deformity. CASE REPORT: In this study, the authors present 3 cases of patients who were treated for the correction of crooked noses using a double lateral osteotomy technique. The aesthetic results and functional outcomes are described. CONCLUSION: In most rhinoplasties, a single lateral osteotomy can be employed, but in patients with a crooked nose, one of the maxillary processes is wider or more prominent than the other. Therefore, a double osteotomy should be employed for excellent aesthetic and functional results.
