I find my nose looks pretty unnatural because of the bump and the unevenness. :-( I am now 5 months postsurgical. do I have an Inverted V-deformity? will these bumps and unevenness become more visible in the next moths? can the look of these deformities be improved? (I would also like to know how difficult is it to additionally shorten the nose (2 mm)? is this procedure of shortening the nose much more difficult for a nose that has already undergone a surgery?) thank you in advance!
I Find my Nose Doesn't Look Pretty Natural. Do I Have an Inverted V- Deformity? (photo)
Doctor Answers 3
Inverted V Deformity
You do appear to have middle vault collapse which is the cause of the inverted V deformity. This can be improved with spreader grafts and at the same time the nose can be further refined.
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Inverted V deformity
I do get a sense of an inverted V appearance to your nose. As your nose heals further it will be easier to get a sense of the final appearance of things. If there's further skin redraping this may become more evident, but you're still early in the healing process.
It is possible to fix narrowing in the area with spreader grafts. Check out my link below to learn more about spreader grafting.
Your nose could be shortened further with revision surgery, though any time we re-enter the nose to revise prior rhinoplasty work it is more difficult than the first time around. This doesn't mean it can't be done; you just want to make sure you have a revision rhinoplasty surgeon who is experienced in doing this type of thing.
Addressing the Inverted-V Deformity in Revision Rhinoplasty
It does appear from your photos that you are developing an inverted-V deformity. This can result when the upper lateral cartilages fall in towards the septum. Over time this issue may become more visible, as the swelling in the skin and soft tissue of the nose dissipates. The issue is corrected by placing spreader grafts, which are long, skinny pieces of cartilage that are usually taken from the septum. These are sutured on either side of the top of your septum, to lift these upper lateral cartilages back outward. If your breathing is affected, this portion of your surgery may be considered medically necessary and perhaps insurance coverage can be obtained. This is called a nasal vestibular stenosis repair. For many patients, I place these spreader grafts during their primary rhinoplasties.
Shortening the nose when you have had prior surgery does require experience and specialized training in revision rhinoplasty, to make sure the structural integrity of the nose is not compromised. Be sure to consult with surgeons who focus on revision rhinoplasty, for whom these maneuvers should not be overly challenging. I also find computer imaging to be a helpful exercise during your consultation, to communicate the aesthetic you are seeking.
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