Do I have an open roof deformity? (Photo)

I had my initial surgery last December. It was an open rhinoplasty to remove a dorsal hump. When the bandages came off I could see two large bumps either side of my nose and it looked to have sunk in above the tip. The surgeon agreed to revise this and did so this July. However, whilst the bumps have gone, I now can see a line up the centre of my nose and it still appears sunken in above the tip. Any advice would be gratefully received. A third revision needed?

Doctor Answers 6

Open roof following rhinoplasty?

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I agree that with one photo is difficult to make an accurate diagnosis.  it would be most helpful to see your profile view.

 It does appear that you have the sometimes referred to us an open roof .  the lying down the center of her nose is probably cartilaginous septum. I also have the sense that your dorsum is slightly low.  You really need to have an exam with consultation for an accurate treatment plan.  Most likely you will require surgery to narrow the bony nasal vault with the  use spreader grafts and possible dorsal onlay graft .  

Best wishes

Santa Barbara Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Inverted V deformity.

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you have an inverted V deformity. This can be corrected after at least six months if not waiting the full year for correction after the swelling goes down. I would need to see other views to determine what else would need to be corrected. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Inverted V deformity

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The deformity can be corrected with a cartilage graft covering the center area or refracturing the nasal bones and moving them more towards the center to blend the central line.

You should give it more time to settle down i.e., a whole year before the third surgery. 


Dr. J

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Nasal Deformity after Rhinoplasty

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Thanks for your post and sharing your concerns. Though it is difficult to determine from a single photo and without an actual exam, you appear to have an inverted V deformity where the position of the upper lateral cartilages in the middle vault region are too narrow for your nasal bone position. The "line" in the center is likely your cartilaginous nasal septum and the "sunken" areas above the tip is from lack of support to your upper lateral cartilages. Your nasal bones may also have a partial open roof. Fortunately, this type of deformity can be corrected with bilateral cartilage spreader grafts and possible revision osteotomies. A dorsal onlay graft to camouflage the bridge may be another option. Unfortunately if the deformity bothers you additional surgery maybe necessary. Best Wishes. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon

Revision Rhinoplasty

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You are four months out from revision surgery. It is difficult to make an accurate assessment because you are still healing and the limitation of the photograph. You could consider placing some filler in the nose to help soften some of the irregularities until the healing is complete. 

Brian Maloney, MD, FACS
Atlanta Facial Plastic Surgeon
4.6 out of 5 stars 35 reviews

Correction after nasal surgery

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From the one photo provided it appears that you have an inverted V deformity.  Correction will most likely require repositioning of the nasal bones and a cartilage graft to the dorsum.  The first step would be an in person consultation.  You need to insure that swelling has completely resolved before the revision procedure is done.  This assessment is also best done with a consultation.

Mark Beaty, MD
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

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