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Is this V inverted deformity? Do I need a revision? (Photo)

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I had septorhinoplasty done to fix breathing. Surgeon removed the dorsal hump and also lifted the tip. At the beginning the profile was straight but then started developing a hump again and what it seems step off from nasal bone to cartilage. How can this be fixed? Do I need revision or can be fixed with permanent filler?

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Dr. Richard G. Reish, MD, FACS
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Dr. William Portuese, MD
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