Can inverted v deformity be corrected with just osteotomies or is spreader grafts always necessary? (Photos)

Question

I think my inverted v is caused by open roof deformity due to osteotomies not being done during primary rhinoplasty. Can osteotomies be done to correct that? I’ve read that spreader grafts with septal cartilage is the best but that most patient don’t have enough left after their primary rhinoplasty. Is this true? I just had a slight hump removal and still have significant height left. How can I know if I have enough septal cartilage? I don’t want to harvest cartilage from somewhere else

Paul N. Afrooz, MD · Answer

It is likely that spreader grafts will be the most effective way to ensure correction of the inverted-V deformity immediately and in the long term.  Osteotomies may narrow the nasal bones and offer a short term solution, but as we age, tissue and skin begins to think in this area making any imperfections more noticeable.  Spreader grafts are reliable way to prevent an inverted-V deformity in the long run.An in-person evaluation is necessary for a more thorough evaluation.  You may very well have enough septum left for spreader grafts.  If not, I routinely use ear cartilage.  If you are opposed to this, your surgeon can discuss cadaveric cartilage options with you.

William Portuese, MD · Answer

To create the inverted V deformity, the nasal bones are excessively wide, AND upper lateral cartilages are concave.  Osteotomies  accomplish narrowing the bridge line, while spreader grafts composed of  patient's own cartilage are performed to widen the upper lateral cartilages. If the upper lateral cartilages are in an acceptable possession, an inverted V deformities probably not present and therefore  only osteotomies are required. For many examples and more information, please see the link and the video below

Richard W. Fleming, MD (retired) · Answer

Usually spreader grafts are necessary to correct an inverted-v nasal deformity but as I said in a previous post an examination is necessary to diagnose the problem. I would not be concerned about harvesting cartilage for these grafts which can be taken from the septum, ears or rarely from the rib.

Can inverted v deformity be corrected with just osteotomies or is spreader grafts always necessary? (Photos)

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Can inverted v deformity be corrected with just osteotomies or is spreader grafts always necessary? (Photos)

Answers (3)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.