What's the difference between an open roof deformity and a inverted v deformity?

They are two different things, but you can have both at the same time. An open roof deformity usually occurs after filing down a bony hump. The nasal bones are like the roof of a house. If you remove the top of the roof, you will have an open space there between the two nasal bones. That's why after taking down a bony hump, one usually has to make cuts in the nasal bones (called osteotomies) to bring the bones inward and "close the open roof."An inverted V deformity is usually a result of collapse of the middle third of the nose. The upper lateral cartilages are attached to the undersurface of the nasal bones by fibrous/ligamentous attachments. If the upper lateral cartilages lose their support and attachments to either the nasal bones and/or nasal septum, they can drop down causing a visible demarcation between the nasal bones and upper lateral cartilages/middle third of the nose. That demarcation usually looks like an upside down "V".Unfortunately both can occur concomitantly or in isolation. I hope this helps. Best of luck.

An Inverted V. deformity is created when the upper lateral cartilages have fallen inward and not in perfect alignment with the nasal bones. This can be related to surgery or trauma. An open roof deformity is created when the hump is removed from the bridge and the osteotomies have not closed the gap, or the nasal bones of healed inadequately

You may have both. Hard to say without photos. Both can be corrected.Find a plastic surgeon with ELITE credentials who performs hundreds
of rhinoplasties and rhinoplasty revisions each year. Then look at the
plastic surgeon's website before and after photo galleries to get a
sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA