What you need to know about a “Saddle Nose”

Rhinoplasty has its own language that can be hard to navigate. Terms like “tip ptosis” and “open roof deformity” aren’t necessarily obvious in what they refer to. Today we’re going to talk about the “saddle nose deformity.” It’s nothing associated with riding a hose, I assure you. But first, BIG NEWS!

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This post about rhinoplasty gets kind of technical. If you’re into that, read on!

If not, thanks for reading anyway! I invite you to check out this post about Asian beauty shots.

A “saddle nose” deformity is when the bottom part of your nose collapses. It looks like this:

See how it looks like a horse’s back when it’s used for saddle riding?

It looks bad but also these patients have severe breathing trouble. Saddle nose deformities are caused when the cartilage of the lower part of your septum collapses. What would do that?

1) Nasal trauma- if you suffer a broken nose, particularly if you’ve had surgery on your nose before, you’re at risk for a fluid collection in your nose called a “septal hematoma.” An untreated septal hematoma can lead to a saddle nose. Bottom line, if you think you broke your nose, get it looked at by someone like me.

2) Surgery- If you’ve had multiple surgeries on your septum, like this patient, you are at risk of a saddle nose.

3) Drugs- Heavy cocaine users are at risk of a saddle nose because the blood supply to your septum gets impaired. Excessive use of intranasal decongestant sprays containing oxymetazoline or phenylephrine can do the same thing!

So how do we fix a saddle nose? You need surgery to restore the strength of the cartilage in the base of your nose. We insert pieces of cartilage in there to rebuild the natural strength of your septum.

Where do we get the cartilage from? Usually in a rhinoplasty we can use extra cartilage that you have in your nose. These patients don’t have that anymore! So we turn to two sources: the patient’s rib cage or the freezer!

The parts of your ribs that insert into your breast bone are made of cartilage. We can use this for rebuilding a collapsed nose. In some people we can take cartilage from their ribs and use it to rebuild their nose. In others, we get frozen cartilage from a tissue bank. This cartilage comes from donors who have died and elected to donate their organs and tissue.

Anyway, it comes frozen in a bag like this:

We defrost it first, then carve out little pieces (like 2-3 mm wide) to rebuild your nose. Usually their breathing is better immediately!


You can see that the saddling is gone and her nose looks a lot better!

For her whole story and all of her before and afters, check out this page in my photo gallery!

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