One Sided Inverted V Deformity? or Full Inverted V Deformity? (photo)

Question

I had revision rhino.2 months ago. My Dr only did a spreader graft on my left side for collapsed cartilage. Do the first 2 pics (before surgery photos) show a total inverted v deformity or one sided? 8 weeks post op (see photos) I am concerned that the right side should've had a graft as well as it looks more and more collapsed/flat/strange as swelling subsides and nostrils are uneven/slightly twisted. I'm worried I had a complete inverted V deformity and only one side got fixed. Please help!

Nima Shemirani, MD · Answer

Dear Amy,

	I do see your concerns, it is still early, and that is not an inverted V deformity

	An inverted V is when the lower 2/3 of the nose has dropped in compared to the upper third, it can happen when the cartilages are not sutured back together

	Spreader grafts widen the middle of the nose, on the right side (before pic), it looks like the tip could use a little width, and that would be a different type of graft/maneuver

	You should visit your surgeon so that all of your concerns can be addressed

	Best regards,

	Nima Shemirani

Steven Wallach, MD · Answer

An inverted "V" deformity occurs in the juncture between the upper 1/3 and lower 2/3 of the nose.  Spreader graft placement can help improve this by widening the middle third. Sometimes the bones hae not been properly reduced as well. This is often unroofed when a dorsal hump is removed.  Hard to say from photos, but at this point you have to wait.

Paul C. Zwiebel, MD (retired) · Answer

Thanks for the good photos.

	While the asymmetry can be seen at this time, it is wise to wait at least 6 months p-op before finalizing the assessment: it takes a bit of time for the swelling to go down and see the "final" effect of the graft you just had.

	It is important to remember that perfect symmetry is rarely attained by surgery (or Mother Nature!). Discuss with your surgeon, if further revison/touch-up will be worth it.

One Sided Inverted V Deformity? or Full Inverted V Deformity? (photo)

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One Sided Inverted V Deformity? or Full Inverted V Deformity? (photo)

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Everything you need to know about Revision Rhinoplasty

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