How can this be fixed? Is this difficult revision and can symmetry be attained? (photos)

I’m 9mths post op. I had open septo-rhinoplasty + spreader grafts. A hump was removed and my columella was trimmed back. I’m really disappointed, broken and feel regretful. There is obvious asymmetry down the bridge of my nose and nostrils and my nose has an obvious bump in the upper third. How can this be fixed? I am apprehensive going back to my ENT doctor, he was initially highly recommended to me for his revision work.

Doctor Answers 3

Rhinoplasty revision for inverted V

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Hi there, I'm sorry you have had a negative outcome from your surgery. There is an inverted V deformity. There is some asymmetry too, but from ther pre op pictures you post I am not sure whether there was preop asymmetry. It is a fixable problem. It requires a further open rhinoplasty. The inverted V is due to the position of the nasal bones, and a lack of smooth transition from the bone to the cartilage, with a seamless transition between the bony vault and the cartilaginous vault. Correcting it requires moving the nasal bones to an ideal position, and rebuilding the cartilaginous vault with more cartilage grafting. Psychologically I know its tough, but correcting it will be worthwhile. You can well go back to your ENT surgeon and I hope you feel you can, but if you require other opinions as well you have every right ot explore that too. All the very best.

How can this be fixed? Is this difficult revision and can symmetry be attained?

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Your nose can be improved by reducing the hump and altering the spreader graft position.

Find a plastic surgeon who performs hundreds of rhinoplasties, has great reviews, and has great before and after pictures.

Kenneth Hughes, MD

Los Angeles, CA


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Based on the pictures posted, you have a nasal hump, inverted V deformity. Major problems with the boney pyramid. Can be corrected with an open rhinoplasty, revise the spreader graft, if there is still septal cartilage left.May be a fascial graft.

Samir Shureih MD. FACS.

Samir Shureih, MD
Baltimore Plastic Surgeon

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