What is the difference between open roof deformity, inverted v deformity, and other deformities that occurs after hump removal?

Question

How does a surgeon distinguish these problems due to overaggressive rhinoplasty of a bridge and distinguish as to what is needed to fix them (narrowing nasal bones, spreader grafts, and so on)? For example, how is inverted v deformity different from open roof deformity or saddle nose?

James Bonaparte, MD, MSc, FRCSC · Answer

Great question! In fact, many medical students ask me this same question. An open roof deformity is just that, like an open roof. Think about it this way, if you live in a house the roof is shaped like a peak (just like your nose). If you then draped a big huge blanket over your roof, it would simulate the skin of your nose. So the skin is resting on the roof. If you were to take a big huge chainsaw and cut the roof off, you'd no longer have a peak to it, but an open roof. Then, the skin (the blanket) would lay flat across the roof and not have a nice shaped dome. This is an open roof deformity. It can happen when you cut the bone of the nose but not narrow it. An inverted V is a bit more difficult to imagine. It basically means the bones of your upper nose become prominant and you get see them and it looks like the letter V upside down. Just shadowing. A saddle nose, is when the tissue of your nose (the roof of your nose) collapse and has a big groove, like a saddle. They are all caused by different things and repaired differently. Dr James P. Bonaparte, MD, MSc, FRCSCOttawa, Ontario, Canada

Toby Mayer, MD · Answer

Experienced surgeons can examine the nose and they know how to differentiate all of the things you mentioned. With experience you learn how to improve these with multiple techniques and their altered depending on the particular problems with the nose.

Brian J. Reagan, MD · Answer

The nasal dorsum is outlined by two slightly curved divergent lines extending from the medial brow to the tip-defining points.  We try to maintain these dorsal aesthetic lines after surgery.  All of the deformities you mention are examples of disruption of the dorsal lines due to different causes.  All can be fixed.  Note that  rhinoplasty revision rates are 5-10 % even in the best of hands.  Seek multiple consults from true rhinoplasty experts.All the Best,Dr. Brian Reagan

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for your question and an experienced surgeon can easily differentiate an open roof (removal of a hump without in fracturing), an inverted V deformity(collapse of the upper lateral cartilages), and a saddle nose deformity(collapse of the nasal dorsum) at your consultationDr Corbin

Richard W. Fleming, MD (retired) · Answer

Hopefully you don't have any of these problems after removal of a hump. Pictures would be very helpful; If I try to describe all of the possible problems it may not help you because it is possible you have a combination of issues. To avoid speculation I need to see you or a full set of pictures of you nose.

What is the difference between open roof deformity, inverted v deformity, and other deformities that occurs after hump removal?

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