Saddle Nose - Best Causes, Symptoms, and Treatment Options Explained

Key Takeaways

• Saddle nose deformity, characterized by the collapse of the nasal bridge, can result from trauma, previous rhinoplasty complications, or medical conditions causing inflammation.
• Treatment options can vary based on the severity of the deformity, with rhinoplasty surgery being the primary correction method. Non-surgical options such as dermal fillers are possible for a minimal saddle nose case.
• Selecting an experienced GMC specialist registered plastic and reconstruction surgeon for rhinoplasty is essential for restoring both the aesthetic and functional aspects of the nose. Find out more about our expert nose surgeons here.

Understanding Saddle Nose Deformity

Saddle nose deformity or saddle deformity is a condition characterized by the collapse of the bridge of the nose. The condition results in a sunken or concave appearance, often referred to as pug nose or boxer’s nose, which can worsen if it is not treated. The term “saddle” is used because the middle portion of the nose appears sunken, much like a saddle. The severity of the deformity can range from minimal to major, where the nostrils may appear broader, giving a ‘short nose’ appearance.

The condition is classified using a three-stage system that assesses the degree of nasal support loss. In major cases, there is a significant lack of both bony and cartilaginous support. The changes in the nasal bridge, resembling the shape of a saddle, are a hallmark of this deformity.

At Kensington Medical our expert nose surgeons can give you expert advice on the next best steps to a natural looking nose. Whether facing a moderate or severe saddle nose deformity, understanding its nature is the first step towards effective treatment.

The Importance of Nasal Structure

The nasal structure is crucial not only for the aesthetics of the face but also for the respiratory function. The nasal septum acts as a central pillar, ensuring the structural stability of the nose. When these structures are compromised, it can lead to significant breathing difficulties and nasal septum perforation, along with altered facial symmetry.

Loss of support within the nasal framework often leads to saddle nose deformity. This can lead to a collapsed nasal bridge and a depressed nasal dorsum, impacting both the nose’s shape and function.

Understanding the importance of nasal structures helps in appreciating the complexity of treating saddle nose deformities.

Causes of Saddle Nose Deformity

Various factors can lead to saddle nose deformity, making it a multifaceted condition. The primary causes include trauma and injury, previous rhinoplasty complications, and medical conditions that cause inflammation. Each of these factors compromises the nasal support structures, leading to the characteristic sunken appearance.

Identifying the root cause of the deformity allows for the selection of appropriate treatment options. The following breaks down these causes in detail, offering a comprehensive understanding of their contribution to saddle nose deformities.

Trauma and Injury

Trauma is the most common cause of saddle nose deformity. Major trauma, such as an accident or sports injury from football or rugby or other contact sports, can compromise the nasal cartilage and septum, including a deviated septum, weakening the support and causing the nasal bridge to collapse. If nasal trauma is not properly managed, the damage can worsen over time, leading to a saddle-shaped indentation.

Conditions like Binder’s syndrome, which involve major malformations, can also lead to significant saddle nose deformity. Timely surgical repair of nasal trauma is crucial to prevent deformity progression and maintain the nose’s shape and function.

Previous Rhinoplasty Complications

Excessive removal of too much cartilage during a primary or secondary rhinoplasty can lead to saddle nose deformity. Complications from a previous nose job often result in alterations to the nasal structure, contributing to deformities such as saddle nose. These complications create challenges in restoring both the nasal aesthetic and function, often worsening the deformity.

Revision rhinoplasty is often necessary to correct saddle nose deformity caused by previous surgeries, aiming to restore structural integrity and appearance using materials like bone, cartilage, tissue grafts, and nasal reconstruction.

Medical Conditions and Inflammation

Chronic inflammation from medical conditions can lead to the gradual development of saddle nose deformity. Infections and inflammation can result in the weakening of the nasal framework, contributing to deformities. Certain autoimmune disorders, such as granulomatosis with polyangiitis and systemic lupus erythematosus, can degrade nose cartilage.

Vascular diseases that cause decreased blood flow to the nasal septum can also lead to saddle nose and septal perforation. The interplay between chronic inflammation, autoimmune disorders, and vascular diseases can collectively result in significant nasal deformities.

Addressing the root causes of inflammation is vital in preventing the progression of saddle nose deformity.

Symptoms and Diagnosis

Symptoms of saddle nose deformity include:

• A noticeable depression in the nasal bridge, which can become more prominent over time
• Nasal pain
• Frequent nosebleeds
• Chronic crusting around the nasal area

Diagnosing saddle nose deformity often involves a thorough examination of these symptoms and their progression.

At Kensington Medical our plastic surgeons can help recognise the symptoms which is key deciding the best options for surgery. The following subsections delve into the visible signs and functional impairments associated with saddle nose deformity.

Visible Signs

The primary visible sign of saddle nose deformity refers to a characteristic sunken appearance. The deformity progresses through three stages: minimal, where there is slight depression; moderate, where there is more significant flattening; and major, where there is severe structural loss.

In cases of moderate saddle nose deformity, the middle section may appear flattened from all views, and the turned up nasal tip may point upwards. Visible signs include varying degrees of nasal bridge depression, from slight to major flattening, and nasal height may also be affected.

These visible changes are often accompanied by a horizontal crease across the nose and altered shape tip projection.

Functional Impairments

Breathing difficulties can occur through one or both nostrils due to saddle nose deformity. The collapse of the nasal bridge significantly impedes airflow, leading to chronic sinus issues and obstructed breathing, including difficulty breathing and nasal obstruction. These impairments can progressively worsen, affecting an individual’s overall well-being and quality of life.

Addressing these functional impairments is essential for improving both the appearance and respiratory function of the nose. Treatment options aim to restore structural support and alleviate breathing difficulties.

Treatment Options for Saddle Nose Deformity

Treatment options for saddle nose deformity range from plastic surgery to non-surgical methods. Rhinoplasty surgery is the primary method used to correct the deformity, particularly in moderate to severe cases. Non-surgical treatments, such as dermal fillers, are also available but mainly for aesthetic improvements in mild cases. Saddle nose treatment is an important consideration for those seeking correction, including rhinoplasty saddle nose deformity and saddle nose rhinoplasty. They can help return the nasal dorsal height.

Choosing the appropriate treatment depends on the severity of the deformity. We explore both surgical reconstruction and non-surgical treatment options in detail.

Surgical Treatments

Rhinoplasty, septorhinoplasty surgery, and revision rhinoplasty are the key surgical procedures for correcting saddle nose deformity. Revision rhinoplasty is often required to address complications from previous surgeries, aiming to restore both form and function. Extensive reconstruction with substantial cartilage grafts is typically required for severe cases of saddle nose deformity.

The materials used in these procedures include bone, cartilage, and tissue grafts, tailored to achieve the desired surgical correction.

Cartilage graft reconstruction is performed for major saddle nose deformities.

Cartilage Grafting Techniques

Cartilage grafting techniques utilise various cartilage sources to restore nasal structure. Common sources include the ear, rib, and nasal septum. Autogenous rib cartilage grafts are preferred for better integration and aesthetics.

Conchal cartilage from the ear is often used for grafts in moderate saddle nose deformity cases. Surgical techniques are tailored based on the severity of the deformity and the availability of cartilage. Batten grafts, spreader grafts, and septal extension grafts are used to restore structure in moderate saddle nose deformities.

Non-Surgical Treatments

Dermal filler injections are used as a non-surgical option for mild cases of saddle nose deformity. These fillers lift the shape of the nasal bridge, improving its appearance. However, treatments with dermal fillers typically need to be repeated every six months to maintain results.

While dermal fillers can enhance appearance, they do not address functional breathing problems associated with saddle nose deformity. They are considered a temporary and primarily aesthetic solution.

Recovery and Aftercare

Post-operative care is crucial for a successful recovery from saddle nose deformity correction. The visible swelling from surgery is expected to decrease in a few weeks, but complete healing of the nose’s internal and external structures may take up to a full year. During the initial recovery phase, patients should avoid activities that could impact the nose and minimize strenuous activities.

There is a minor risk of infection or bleeding after the procedure, so following the surgeon’s post-operative care instructions is essential. Proper aftercare ensures the nose surgery heals correctly and maintains its new shape and function.

Choosing the Right Specialist for Saddle Nose Correction

Selecting a plastic and reconstructive surgeon with extensive experience in rhinoplasty is crucial for achieving the best outcomes when correcting saddle nose deformities. A qualified surgeon understands the complex anatomy of the nose and how to effectively restore both its form and function.

At Kensington Medical our GMC specialist plastic and reconstructive surgeons who specialise in nose surgery have decades of experience. They can help you understand what best options to take. Book a saddle nose consultation to find out more.

Frequently Asked Questions