Long-Term Outcomes of Crooked Nose Correction: The Value of Instrumental Diagnosis Trough Nasal Grid Analysis.

: Rhinoplasty is a leading cosmetic surgery, with the crooked nose being one of the most complex challenges due to its combination of functional and aesthetic issues. Involving multiple nasal components, a crooked nose remains difficult to correct, with a high recurrence rate. The aim of this study was to analyze the long-term outcomes and stability of the nasal pyramid after surgery through a nasal grid analysis. : A retrospective study was conducted on 360 patients (20 men and 16 women) treated for moderate to severe nasal deviation between January 2014 and January 2020. All patients underwent surgery by the same expert surgeon, with follow-ups extending to at least 24 months. Medical records, physical exams, and standardized photographic evaluations were used to assess outcomes. A nasal grid was adapted to analyze the long-term stability of nasal corrections, focusing on individual post-operative changes. : The study involved 360 patients, mostly men aged 22 to 65, with the majority having nasal deviations caused by extrinsic trauma (e.g., sports injuries). Nasal deviations affected various parts of the nose, and all patients underwent follow-up evaluations using a nasal grid to compare pre- and post-operative measurements. The results showed long-term stability in nasal corrections, with minimal changes observed between 1 month and 24 months post-surgery. Only one case had partial recurrence, requiring revision surgery, which was successful. : The surgical correction of a crooked nose is complex and requires a personalized approach, particularly for severe septal deviations. Complete anatomical reconstruction, using advanced techniques like extracorporeal septal reconstruction and laser osteotomies, provides stable long-term results. The adapted nasal grid proved to be not only an effective post-operative assessment tool but also shows potential for the pre-operative classification of nasal deformity complexity. Although this study focused on a standardized surgical technique, future comparative analyses with alternative approaches are recommended to further validate the outcomes.