After how many months can I correct my inverted v deformity from the first rhinoplasty? (Photos)

Hello and thank you for your question.

Although an exam in person is ideal, from your photographs alone, I agree that you have an inverted V deformity where the keystone area is disrupted -- this is where the nasal bones overlap with cartilage along the junction of upper third and middle third of the nose.

The first step is to recognize that complications happen to all surgeons, and those surgeons that don't have complications are either not operating enough or are lying.

The second step is to figure out a solution. The inverted V deformity is fixed with spreader grafts to correct that bone-cartilage disruption, and realign the streamlined look of your nose. Due to your prior rhinoplasty, the cartilage in your septum was likely harvested and so you will likely require MTF (Musculoskeletal Transplant Foundation) aka cadaver cartilage to obtain the necessary cartilage grafting to perform this revision rhinoplasty. Of note, you may also benefit from tip refinement, where further modification of your nasal cartilage can be done with trimming, stitching and grafting. In terms of function, please note that if your septum is deviated and you have breathing difficulty, a septoplasty may benefit you as well.

As for the final step -- since you are 3 months out, I would recommend waiting 1 year for most (if not all) of the swelling to improve and then pursuing the right aesthetic plastic surgeon for your revision rhinoplasty. Please recognize that may still be your original surgeon -- remember, complications happen to ALL surgeons.

Please note, however, that in your (revision) rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course. Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. I think the most important component of the consultation is to establish a good connection with your plastic surgeon. It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

We can see that the upper 1/3 of your nose was made a bit too low. Depending on your examination, microdroplet Silikon-1000 injections may be considered for permanently replacing lost volume and for improving upon your nasal profile appearance without the inconvenience of additional surgery. Procedures can be commenced as early as one month post-operative, depending on somebody's situation. I hope this helps, and I wish you well moving forward. Sincerely, Dr Joseph

Hello and thank you for your question. Based on your photographs, a revision can address these issues. Depending on your specific anatomy, some surgeons will recommend waiting until after one year. In certain situations, it may be safe to do the revision as soon as eight months postop. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon