Inverted V Deformity - Two Months Post-op? (photo)

The first days before my cast went off it looked fine, although I saw a very diffuse purple-grayish mark between my nose bone and cartilages. I though it was part of the natural swelling, and in later revisions, my surgeon said it was ok. But now I'm afraid I'm developing an inverted v deformity, my nose shape is not continuous and straight, losing definition somewhere in the middle and having this noticeable dent in the right side. Is this gonna get worse over next months?

Doctor Answers 6

Inverted V Deformity after Rhinoplasty

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    I do notice some irregularity in the middle third, but I cannot say from these photos that you are developing anything.  At two months, this may just be swelling.  Hard to say without an exam.  Kenneth Hughes, MD Los Angeles, CA

Inverted V deformity

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It is hard to tell form your photos, but over time if you have an inverted V deformity  as the swelling goes down it will be more apparent.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Inverted v deformity

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This occurs when the nasal cartilages get separated from the the nasal bones and collapse forming an inverted v shaped deformity. You tell a few months after surgery that this is developing. After 9-12 months it should become more obvious.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon

Inverted V Deformity - Two Months Post-op? (photo)

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Time will tell. But I see NO inverted V deformity as you call it in your posted photos! Best to allow 4 to 6 months healing time. 

Hard to tell from photos

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It is difficult to say without seeing in person, but the photos do give some suggestion of an inverted V deformity. The nose will continue to undergo changes over the entire 1st year, sometimes even longer, so it is still too early to say what the final results will be. 


That said, if you do end up with an inverted V deformity, the solution would be revision with spreader grafts to restore volume and width to the mid 1/3 of the nose and reestablish better continuity between the nasal bones, upper lateral cartilages, and septum. I would recommend seeing a surgeon experienced in revision rhinoplasty if that were necessary in the future.


Good luck and try to be patient for the meantime. Things could still work out ok.

Possible inverted-V deformity after rhinoplasty

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From your photos I do get a sense that you may be developing pinching in the middle third of your nose. The tissue healing process in this area can evolve over the course of a year or so.

The typical treatment for this problem is to place spreader grafts which can re-support your nose in the area of collapse.

You can read more about spreader grafts at my web reference link below.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

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