What is this V shape caused by? What is the name of this area and what needs to be done to fix this? (Photos)

There are many reasons for deformities of the columella after.  This can include resection and destruction of the medial crura, failure to identify excessive curvature in the medial crura , poor placement of columellar grafts and struts, failure to identify deformity in the medial crural footplates, and a persistent deviation of the nasal septum.  It appears that your left nostril has what you are calling a "V-shape" as a result of your columella being pushed over to the left most likely due to a deviation in your nasal septum.  This is pushing your medial crura outward into the your nostril creating what you are calling this V shape.  I would recommend waiting a full year for final swelling to settle down before contemplating a revision.

Click on the "Web reference" link, just below my response, or go here:

FacialSurgery.com/RealSelf/RealSelf_lookitscrystal.html



I made a couple of computer morphs of your nose, and animations of the morphs, to show the changes that are possible for your nose in truly expert hands.

The main change I made was to elevate the tip of your nose. Your tip droops, and your nose is begging for a large elevation of the tip. Then, I also brought the entire nose back closer to your face, and narrowed the tip.

The V-shape you see is the drooping of the tip, which is improved by elevating the tip, like I did for the revision lady in the short video just above.

I'm curious whether the morphs fit with what you feel is a good goal for your nose. Did I raise the tip enough?

I reviewed your previous posts, too. With all due respect, you can't select a rhinoplasty surgeon based on his bedside manner. It just doesn't mean anything at all. Neither does board certifications or academic appointments or any of that alphabet soup stuff. In the link, underneath the morphs, I discuss how to find a good plastic surgeon.

I also have a section where I discuss how to tell whether you should let your primary surgeon do your revision. You need to read that section very, very carefully. All clues indicate that you should not.

The good news is that shortening a nose is one of the most predictable changes to make in a rhinoplasty, even in a revision.



You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.





Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.

We only see one frontal preoperative photo. You appear to have a long and wide nasal appearance with a droopy nasal tip. The base view of your nose may reveal a deviated nasal septum. Revision surgery may be considered at 12 months postoperative, so now is a good time to begin consulting with rhinoplasty specialists. It may be helpful bringing a copy of your operative report and preoperative photos to your consultations. Depending on your condition, well-performed surgery may lead to improvement in both your nasal appearance and breathing. Wishing you all the best moving forward. Dr Joseph