prevention of the inverted 'v' deformity and collapse of the middle vault after rhinoplasty
The inverted ‘V’ deformity and collapse of the ‘middle vault’
An explanation of the inverted 'V' deformity and how spreader grafts prevent collapse of the middle vault and widen the internal valve. Usually done through an 'open' rhinoplasty approach although Jack Sheen, who popularized this technique, always inserted spreader grafts through a closed rhinoplasty approach. Spreader grafts using cartilage from the septum or ear or the leading upper edge of the upper lateral cartilage, are all designed to maintain the internal valve angle and to prevent collapse of short nasal bones and the middle part of the bridge of the nose - called the middle vault - which can lead to late 'inverted 'V' defromity' and prominence of the nasal bones - even after several years.