Could this be an inverted V deformity 1.5 years after rhinoplasty, or is it likely just normal contouring? (Photos)

Question

I am about 1.5 years post rhinoplasty. Aesthetically, I actually like the appearance of my nose overall and I do not feel that it looks obviously collapsed or progressively worse over time. However, I became worried after reading about inverted V deformity online and comparing photos. I notice a slight shadow/indentation in the middle vault area in certain lighting or angles, especially with flash photos from below, and now I am worried it could represent an inverted V deformity. I also sometimes feel like my breathing is not perfect, especially in the mornings when I often wake up feeling congested or stuffy, although during the day it is usually manageable. My main concern is whether this looks like a true structural inverted V deformity that could continue worsening over time, or whether mild contour irregularities/shadowing after rhinoplasty can look similar in photos without representing significant collapse. Since I am already 1.5 years post-op and the appearance has been relatively stable, is it less likely that this would progressively collapse or require revision surgery later? I would appreciate opinions regarding both the appearance and the functional aspect.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. I never recommend pulling on your nose or applying pressure to try to show a defect. It must be evaluated in normal positions. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Kadir Berat Oyur, MD · Answer

It is very common to feel a sense of anxiety when you begin to notice subtle shadows or contour changes that resemble things you’ve read about online, but at 1.5 years post-op, the stability of your nose is a very positive sign. An "Inverted V deformity" typically occurs when the upper lateral cartilages collapse inward, often leading to a visible disconnect in the mid-vault; however, what you are seeing in certain lighting may simply be a mild contour irregularity or the natural "draping" of the skin over the underlying nasal structure as the final swelling has subsided. Given that your appearance has remained consistent and your breathing issues are mostly confined to the mornings which often points toward seasonal allergies or nighttime congestion rather than a permanent structural collapse it is unlikely that you are facing a progressive deformity. While a physical examination is the only way to confirm the structural integrity of your internal valves, the fact that you generally like the aesthetic and the nose has held its shape for eighteen months suggests that a major revision may not be necessary.

Could this be an inverted V deformity 1.5 years after rhinoplasty, or is it likely just normal contouring? (Photos)

Answers (2)

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