Feel like i've got Inverted V Deformity? Im 7 month post op with thick skin, any chance this is just apart of healing or bad nose job?

Bad news, but real. At 7 months with thick skin, that V shadow is almost certainly an inverted V deformity, not edema. Had a patient last year almost identical to your story. Thick skin, primary rhinoplasty done elsewhere, the V showing up around month six just as her edema dropped. The mechanics are simple. Hump came down at primary, surgeon didn't place spreader grafts to hold the middle vault open, upper laterals collapsed medially, and the bony pyramid above ends up sitting wider than the unsupported cartilages below. Thick skin hides it longer. We took her to the OR around month thirteen. Rebuilt the vault with spreader grafts harvested off the septum, restored the dorsal aesthetic lines, and the V was gone. Her nasal valve and breathing got better too, which often goes hand in hand with inverted V. Give your own nose to month twelve before scheduling, then consult surgeons who specifically do revision rhinoplasty. #StayBeautiful, @RealDrWorldWide

Thank you for your question — I understand your concern, especially at this stage of healing. What you’re referring to as an inverted V deformity is a known structural issue that can sometimes occur after rhinoplasty, typically related to the junction between the nasal bones and the upper lateral cartilages. At around 7 months post-op, especially in patients with thicker skin, there can still be residual swelling that may create irregular contours or shadows that mimic this appearance. However, it’s important to understand: • True inverted V deformity is usually due to structural factors (such as collapse or separation in that area) • Swelling-related irregularities tend to improve gradually over time In many cases, the final result of a rhinoplasty — particularly with thick skin — may take up to 12–18 months to fully settle. At this stage, what I typically recommend is: • Careful observation over the next few months • Follow-up with your original surgeon for evaluation • In some cases, non-surgical options like steroid injections may help if swelling is contributing If the appearance persists closer to the 12-month mark, then a structural issue becomes more likely, and a revision rhinoplasty may be considered. The key point is that at 7 months, it is still possible that what you’re seeing is part of the healing process — but it’s also reasonable to monitor closely. A proper in-person assessment will help distinguish between residual swelling and a true structural concern.

We can not exacly tell what's happening by looking photos. It's early to say something before 1 year. It's better to consult your own surgeon who does the surgery.

At 7 months post-rhinoplasty, you are still within the healing window — especially with thick skin, which takes significantly longer to settle and show final results. Full rhinoplasty results in thick-skinned patients can take 18 months to 2 years or even longer. That said, an inverted V deformity is a recognized complication of rhinoplasty that occurs when the upper lateral cartilages separate or collapse away from the nasal bones after osteotomies, creating a visible shadow or line along the bridge. It can sometimes be confused with normal post-surgical swelling patterns during the healing phase. Given that you're only 7 months out, there is still a reasonable chance that continued swelling resolution will improve the appearance. However, if the inverted V shape becomes more pronounced as swelling subsides rather than less, it may indicate that the upper lateral cartilages need to be addressed with spreader grafts in a revision procedure. My recommendation would be to continue following up with your surgeon and give it more time. Take consistent photos monthly to track changes. If by 12-18 months the appearance has not improved or has worsened, a consultation with a revision rhinoplasty specialist would be a good next step. Try to be patient — thick skin healing after rhinoplasty is a marathon, not a sprint.

Question: Do I have an inverted-V deformity after my rhinoplasty? I’ve included photos. Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery – Frisco, TX: Thank you for your question and for sharing your photos, those are very helpful in evaluating your concerns. Based on what you’ve described and the images you provided, it’s possible that you’re showing signs consistent with what we call an inverted-V deformity. But let me explain what that means, why it happens, and how we typically address it. ⸻

Hello, thank you for your question. Based on your photo and description, the appearance of an Inverted V deformity can sometimes be seen after rhinoplasty, especially if the nasal cartilage is weakened or over-resected. At 7 months post-op with thick skin, some residual swelling and healing changes may still be present, which can affect the nose’s shape and contour. However, if the deformity is prominent and consistent, it may indicate structural issues from the surgery rather than just healing. I recommend discussing this concern with your surgeon for a thorough evaluation. They can determine if this is a temporary phase of healing or if revision surgery might be necessary to address any cartilage support problems.

Hard to tell from this angle only - would need side profile shots from both sides and better front photos to help identify V deformity or any deformity. There seems to be some type of small deformity in your close up photo (but hard to tell from the limited photos). Definitely revisit with your surgeon to see if there's an idea what could be possibly there (and then try seeking a second opinion to see if there's an agreement).

Hi thank you for your question and photos. An Inverted V deformity can occur after rhinioplasty surgery. Its appearance is just as it sounds, an upside down V shaped shadow over the bridge of the nose. This can result removing a dorsal hump, but not addressing the width of the midvalt (the cartilage portion of the bridge of the nose). The appearance of this deformity is the result of the middle portion of the nose being too narow with respect to the upper 1/3 (bony portion) of the nasal bridge. It can be repaired with cartilage grafts called spreader grafts during a revision rhinoplasty. Since you are just 7 months out from surgery, I would recommend waiting until 12 months to allow any remaining swelling to go down before deciding whether you would like to have a revision surgery. Hope this helps. Catherine Weng MD FACS

Buen día, Debes esperar el proceso desinflamatorio y consultar con tu cirujano si va bien tu recuperación.

Ozge Ergun, MD First, the lateral osteotomy procedure wasn't very effective. I recommend filling the nasal dorsum with diced cartilage along with the lateral osteotomy. A cartilage graft can be used to restore the nasal tip. Additionally, narrowing the alar base can be considered. At least one year must pass after surgery to plan for all of this.

Feel like I have inverted V Deformity, any chance this is just apart of healing or bad nose job? (Photos)

Rhinoplasty - what would you do to improve my nose? (Photos)

I can tell you the four buckets I sort patients into when they ask "what would you do." Dorsum (bump, scoop, width). Tip (bulbous, droopy, asymmetric, undefined). Base (nostril width, sill flare, columellar show). Profile and projection. Most patients need work in two of those four, not all four...

Feel like I have inverted V Deformity, any chance this is just apart of healing or bad nose job? (Photos)

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Answers (58)

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