Saddle nose deformity is not a disease it the clinical description/ appearance of the nose that occurs occurs following loss of support of the nose from destruction of the nasal septum. This lack of support produces a typical concavity to the bridge of the nose in side (profile) view – like the shape of a horse’s saddle, hence the term ‘saddle nose deformity’. This deformity progressively causes increased breathing difficulties for the patient and the appearance is quite distressing for most patients.
Any process that weakens the septum can produce a saddle nose deformity:
Over resection/removal of the septum from poorly performed septoplasty, rhinoplasty
Cocaine nose damage to the septum
Vasculitic disease that weakens the septum through inflammation
Large perforations in the nasal septum
Correcting the saddle requires rebuilding of the septum to re-support the mid portion of the nose. We do this by taking cartilage grafts from ears or from your rib cartilage.
There are various grading systems to saddle nose deformity. The majority can be corrected in a one-stage procedure as a day case patient. Extreme cases may require more than one stage to successfully reconstruct the nose.
Nasal collapse from a vasculitic process which has produce a severe septal saddle nose deformity, reconstructed with rib cartilage in one operation.
If necessary rib cartilage can be taken and sculpted to completely replace all of the septum and upper laterals if required as shown above. Yellow arrow indicates healed scar, in women this scar is hidden under the breast crease (without changing the shape of the breasts).
Saddle Nose Deformity and Correction FAQs
What is saddle nose deformity?
Saddle nose deformity is a condition in which the bridge of the nose appears sunken or concave, producing a “saddle-like” appearance on profile. This occurs when the nasal septum and surrounding cartilage or bone lose adequate structural support.
What causes saddle nose deformity?
The most common causes include:rnTrauma or injury to the nosernExcessive removal of cartilage during septoplasty or rhinoplastyrnChronic intranasal drug use (especially cocaine)rnAutoimmune or vasculitic diseases that damage nasal tissuernLarge septal perforations
What are the symptoms associated with saddle nose deformity?
Patients often experience a flattened nasal bridge along with functional symptoms. These may include:rnDifficulty breathing through the nose
How is saddle nose deformity diagnosed?
Diagnosis is usually made through physical examination and a review of the patient’s medical history. In some cases, further testing is needed to identify autoimmune, infectious, or inflammatory conditions contributing to nasal tissue loss.
Who is at risk for developing saddle nose deformity?
People most at risk include those with prior nasal trauma, individuals who have undergone surgeries with excessive cartilage removal, patients with chronic intranasal drug use, and individuals with autoimmune or inflammatory conditions.
Can saddle nose deformity worsen if untreated?
Yes. Over time, the weakening of nasal structure can progress, resulting in more pronounced cosmetic changes as well as worsening nasal airflow obstruction.
What surgical options are available for correcting saddle nose deformity?
Surgical correction usually involves reconstruction with cartilage grafts, which may be taken from the patient’s ear or rib.rnMost cases can be corrected in a single stagernSevere deformities may require multiple staged surgeries
What are cartilage grafts, and why are they used?
Cartilage grafts are pieces of cartilage harvested from elsewhere in the body (rib/ear). They restore the shape and contour of the nose, reinforce weakened structures, and help maintain normal breathing function.
What is the typical recovery process after saddle nose repair?
Most surgeries are performed as outpatient procedures. Recovery includes avoiding strenuous exercise for several weeks, managing swelling and bruising, and following detailed aftercare instructions. Full healing and graft adaptation usually take several months.
Are there different severities or grades of saddle nose deformity?
Yes. The condition ranges from minimal to severe. Mild to moderate cases are often correctable in one procedure. Severe deformities may rarely require complex, staged reconstruction
