Inverted V or Wide Nasal Bones?

I had close rhino 14mths ago to reduced hump on my nose,tip shortened and septoplasty. I wasn't happy with the width of my nose when the cast come off as well as now. I have visible and palpable dent where bone meet uper cardilage. My front looks very flat and wide and I still tape my nose over night and it seems better for few hours.Also I have developed a small bump in middle of my bridge and one on the root of the nose. Under light my nose look more deformed. what I should do to correct it

Doctor Answers 5

Inverted V deformity and wide nasal bones

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From your photos and description you appear to have both an open roof deformity an upper lateral cartilage collapse.

The open roof results when a hump is removed off the bridge but the nasal bones aren't properly in-fractured. This can be done during revision surgery, though.

The inverted V results when the upper lateral cartilages collapse and lose their attachment to the nasal bones. Spreader grafts can be placed in the area during revision rhinoplasty to resupport the area and recreate a more seamless nasal contour.

If you'd like more information about what spreader grafting entails check out my link below that discusses spreader grafts in more depth.

Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Inverted V Deformity and Wide Nasal Bones

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You do have increased width of the nasal bridge and an open roof which can be corrected with repeat osteotomies to reposition the nasal bones. Cartilage grafts immediately below the  bones will support the middle of your nose to eliminate the inverted V deformity, improve appearance, and improve nasal breathing.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Revision rhinoplasty

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You may be a candidate for a revision rhinoplasty, but the best way to determine this, is to go for a consult and get evaluated.

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

Inverted V "deformity" and wide nasal bones

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I think you have both an "open roof" and an "inverted V" problem.  When the bony part of a hump is taken down, frequently osteotomies,  or cuts in the nasal bones on both sides are required to bring the bones together a bit and prevent a flat spot over the upper bridge.  In addition, if you have collapse of the upper lateral cartilages, which attach to the underside of the nasal bones, the transition from the lower edge of the bone to the middle 1/3 of the nose can be exaggerated and appear as an upside down 'V', also called an "inverted V deformity".  I'm afraid that at 14 months you will require revision to correct these issues. 

Matthew Bridges, MD
Richmond Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Inverted-V deformity following rhinoplasty.

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Hello.  I am sorry things have not gone exactly to your liking.  I agree that there are some issues with the appearance of your nose. 

An inverted-V deformity results from excessive pinching of the upper lateral cartilages at bone-cartilage junction of the nasal dorsum otherwise known as the rhinion.  Many rhinoplasty surgeons currently use spreader grafts to stabilize the width across this area.  Spreader grafts are difficult if not impossible to accurately place and immobilize through a closed rhinoplasty. 

In your situation there are definitely cartilage and bone irregularities resulting in contour deformities over the middle dorsum, a wavering dorsal nasal aesthetic line and an irregular profile with relative prominence (bump) at the rhinion.  Without examining your nose it is hard to say exactly which structures are contributing to the appearance, i.e. the nasal bones, the upper lateral cartilages.  My guess is that the upper lateral cartilages have been separated from the nasal bones and collapsed and the nasal bones are not adequately narrowed.   

In all likelihood, you will want some type of revision.  I suggest you start by re-visiting with your surgeon to discuss the issues and based on that meeting you may want additional opinions.

Best of luck.

Mario J. Imola, MD, DDS, FRCSC.


Mario J. Imola, MD, DDS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 124 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.