Do I have an Open Roof Deformity? (photos)

I have had revision rhinoplasty 4 month ago to refine the bridge and the tip. I'm not happy with the upper portion of the nose bridge. My surgeon told me he could rasp the side of the nasal bone to make it narrower. he told me that breaking my nose a second time is not a good idea.. Im very septic about it. What do you think i should do? Thank you very much for your answers

Doctor Answers 6

Open Roof Deformity

It's hard to tell if you have an open roof deformity from looking at a photo, but if you are unhappy with the width of the upper part of your nose, then this can generally be narrowed with osteotomies or breaking of the bones.  Rebreaking the nasal bones is usually not a big concern.  Please consult with a board certified specialist who can help you achieve the results you seek.  3-dimensional computer imaging can also help you visualize what you may look like afterwards and serve as an important communication tool with your surgeon.

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Narrowing of the upper third of the nose may be achieved with osteotomies during rhinoplasty surgery.

The bridge of the nose is similar to an A-Framed roof. When the bony bridge is lowered, there may be widening, hence the phrase - "open roof". In our experience, narrowing of the upper third of the nose may be achieved with osteotomies. Your close up photos are difficult to interpret. Since you have concerns, consider consulting with several rhinoplasty specialists so you could see what might be best for you. Hope this helps. Dr Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 386 reviews

Revision rhinoplasty again at one year

The bridge line appears very flat and square top-ish, therefore an open roof may be present. To confirm an open roof requires an examination of the nose. To close the open roof requires osteotomies placed in the nasal bones which is acceptable after primary, secondary, or a tertiary rhinoplasty. Best to seek out a very experienced surgeon for best results. Revision rhinoplasty is a very difficult endeavor, and one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Widened nasal bridge

Widened nasal bridge can occur postoperatively and is due to residual bone that is left following rasping of the dorsum; this bone can fall into the sides of the nose and not completely removed; following resolution of your swelling, this material can then form back into a solid bone; this bone can easily be rasped out in the office under local anesthetic solution without the need for a full anesthetic surgery and unnecessary costs.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 41 reviews

Do I Have an Open Roof Deformity?

At this time I would be patient because you're just 4 months post-op. With these pictures it is difficult to tell if you have an open roof deformity or increase width of the nasal bones. Having said that i would not be concerned about breaking the nose (doing osteotomies) if that is necessary.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Revision rhinoplasty for an open roof.

It is too soon to say if this will get better or worse. You may need the bones narrowed and spreader grafts placed. See your surgeon in several months and discuss this with him. If dissatisfied seek a second opinion from a very experienced revision rhinoplasty surgeon.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 32 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.