{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T16:45:25Z","timestamp":1792169125365,"version":"4.4.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Correction of nasal axis deviation in rhinoplasty is challenging. Effective treatments include osteotomies and the use of asymmetric spreader grafts or flaps to push the axis towards the midline. Despite best efforts, however, recurring and\/or residual deviations are very common.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to examine the results of asymmetric let-down osteotomies in correction of nasal deviations and compare these to traditional and well-established structural rhinoplasty techniques .<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This work involved a prospective, randomized, blinded study, for which 64 patients with severe nasal axis deviations were enrolled and randomly assigned to control and experimental groups (n = 32). Experimental group patients underwent nasal axis deviation correction with the asymmetric let-down technique; control group patients underwent a conventional structural rhinoplasty with dorsal reconstruction using spreader flaps or grafts. Data were extracted from pre- and postoperative photographs, operative notes, and patient files, and used to assess the effectiveness of asymmetric bone impaction and to compare the results between the 2 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>An analysis of the data showed that asymmetric bone impaction resulted in 90% \u00b1 5.67% correction in axis deviation at the 12th month postsurgery. Comparison of the 1st and 12th month postoperative results showed no statistically significant recurrence (P \u00a0&amp;gt; .05). A statistical analysis comparing the groups showed significantly better correction of nasal axis deviations in the experimental group (P \u00a0&amp;lt; .01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Asymmetric bone impaction can be successfully used to correct crooked noses, adding to the armamentarium of surgeons as a viable alternative for the correction of axis deviations in crooked noses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 2 (Therapeutic)<\/jats:title>\n                    <jats:p>For image description, please refer to the figure legend and surrounding text.<\/jats:p>\n                  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