Doctor only doing 1 spreader graft for Inverted V -- Do I need both sides? (photo)

Question

I recently went to see my surgeon b/c part of my nose is sunken in -- he agreed and said I would need a revision with spreader graft on that one side. Here is my concern: I am also asking him to shave down bridge more and refine the tip more. From what I've read, the Inverted V comes from shaving bridge -- I am concerned the other side (w/o graft) will fall in after this surgery. Should I ask for him to do both sides? or trust his judgement on only doing 1 side. I can't afford a 3rd surgery!

Eric M. Joseph, MD · Answer

If you're planning on pursuing a revision rhinoplasty, it may be best to address your entire nose. Based on your photos, your nose is slightly long with a droopy tip. The "inverted-V", or indentation below your small bump is noticeable on your last photo. Depending on your examination, you may be a candidate for tip refinement and rotation, along with bridge lowering for a smaller, more feminine nasal appearance. The advisability of one or two spreader grafts would require an examination.Wishing you all my best.Dr. Joseph

Kian Karimi, MD, FACS · Answer

It is sometimes difficult to know if one will require one spreader graft, two spreader grafts, or even what is known as a "double" spreader graft for significant collapse until the time of surgery, especially if more of a hump is going to be taken down.  I would leave it up to the judgment of your surgeon as long as you have confidence in his work.  I would make sure your surgeon is a facial plastic surgeon or a plastic surgeon who specializes in revision rhinoplasty.

William Portuese, MD · Answer

The photograph demonstrates a asymmetrical nasal bones and an inverted V. with concavity of the upper lateral cartilage both on the same side. Osteotomies of the nasal bones, a right-sided spreader graft and  shaving down the dorsal hump is all that is required. For more information and many examples, please see the link and video below

Steven Wallach, MD · Answer

A revision sounds reasonable.  It may be that during the procedure you may need spreader graft on one side or even both sides.  Good luck.

Doctor only doing 1 spreader graft for Inverted V -- Do I need both sides? (photo)

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Doctor only doing 1 spreader graft for Inverted V -- Do I need both sides? (photo)

Answers (4)

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