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?

This is very likely an inverted V, however the views submitted could be misleading. If a large hump was removed, and proper osteotomies were not performed and spreader grafts were not placed, an inverted V can easily occur. In order to correct this issue, proper bone work and reconstruction of the midvault with proper spreader grafts is required.

I understand your concern, and the honest answer is: it could be either, and the only way to know is an examination. The appearance you are describing happens when the middle part of the nose looks narrower than the bones above it, creating a subtle upside-down "V" shadow on the bridge. Sometimes this is simply part of healing especially with thick skin, swelling settles unevenly and slowly, and at 7 months your nose is still changing. In thick-skinned noses, the final shape can take 12 to 18 months to fully reveal itself, so what you see today is not necessarily your final result.That said, if the narrowing is structural meaning the support in the middle part of the nose was weakened during surgery it typically does not improve on its own and becomes slightly more visible as the remaining swelling fades. The distinction matters, because one situation only needs patience, while the other benefits from being identified early so you can plan properly. The good news either way: even when it is structural, this is a well-understood issue that can be corrected, and correction is much easier to plan when the nose is assessed by hand, not just by photos.

Hello Considerate548, Thank you for your photographs and query about potential post rhinoplasty middle vault collapse. Whilst the diagnosis should only be made following clinical review, the inverted 'V' deformity is often most obvious in photographs. I can see nasal dorsal aesthetic line asymmetry and subtle inverted 'V' deformity in your photos. May I suggest consulting with your surgeon, in particular if you have any other symptoms of middle vault collapse such as nasal airway obstruction related to internal nasal valve collapse. Your surgeon will be able to advise you regarding spreader graft insertion to address the issue and if these grafts were utilised during your surgery. Best wishes Dr Sugitha Seneviratne FRACS (plast)Specialist Plastic Surgeon

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

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