What is an Open Roof Deformity?

An open roof is difficult to describe without a model. Thin of an A-frame house. Now imagine removing a longitudinal piece of the peak of the roof. This would leave and "open roof" between the two opposing sides of the roof. To close it you would have to collapse the two remaining portions of the roof together to cre-create the peak of the roof.
This is somewhat similar to the nose where the two nasal sidewalls remain after removing the hump. These bones must be pinched together to close an "open roof".
In patients who have very thick skin and a small hump with resulting small open roof, some surgeons leave it open and it remains stable. However, in thinner skinned individuals the gap and edges of the sidewalls can become visible over time as the skin swelling subsides. This may give the impression that it worsens over time.

An open roof deformity is one that has a wide nasal dorsum and usually is due to not being closed after taking down a dorsal hump. This is usually done by doing osteotomies to close the open roof. It should only be done by those with experience and expertise in rhinoplasty.

An "Open Roof Deformity" can occur after a rhinoplasty if the surgeon reduces the bone and cartilage along the bridge and inadequately repairs the defect. It can usually be repaired in one of several ways:

1) Re-breaking the bones.

2) Placement of new cartilage grafts (called Spreader Grafts).

3) Camouflage with other types of nasal grafts (Fascia and Diced Cartilage).

These are common strategies that I use in revision (aka secondary) rhinoplasty operations.