Unhappy with Front View of Nose Since Nasal Hump Removed? (photo)

I had surgery in 2008, a hump removed & slight work to the tip. I am very unhappy with my nose from the front now it looks wider, flat, has no definition and doesnt look symmetrical, it looks even worse in photos to the point where I will avoid photos taken. I went back and saw my surgeon a couple of years ago discussed this with him and he said he didnt see any problem and not to have more surgery. I feel overall my nose doesnt look or feel right it feels lumpy and uneven, hard lump down centre.

Doctor Answers 6

Correcting the inverted V deformity during rhinoplasty

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From these photos, it seems you have what's called an inverted-V deformity, related to the falling in of your upper lateral cartilages up against your septum. This can occur after the removal of a nasal hump if there is inadequate support to these upper lateral cartilages. Correction of this issue is achieved during a revision rhinoplasty with the placement of spreader grafts along the bridge portion of the septum, to lift these cartilages back out and smooth out the bridge of the nose. These spreader grafts are made out of your own cartilage, taken from your septum.

If you are having difficulty breathing, your insurance may cover a significant portion of the cost of your surgery, as you may have a medical issue called nasal vestibular stenosis, which is narrowing of the internal valves of your nose. Try placing your finger on your cheek next to your nose and pulling out to the side (Cottle maneuver). If your breathing seems better with this maneuver or with Breathe-Rite nasal strips, you may be a candidate for repair of this issue. The bony bumps on your bridge can also be gently filed down during revision rhinoplasty.

Be sure to seek consultations with a few surgeons who specialize in revision rhinoplasty, and make sure they can appreciate the issues with which you are concerned and give you a concrete plan to correct them.

Best regards,

Dr. Mehta

Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 52 reviews

Unhappy with Front View of Nose

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     Although the shadowing on the first picture suggests an inverted V, I would have to examine you before making any specific recommendations.  Kenneth Hughes, MD Los Angeles, CA

What to do if you are not happy with your rhinoplasty

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You need to visit an expert revision rhinoplasty surgeon in your area to assess your nose. From a limited view of your nasal pictures, it appears that you have had dorsal reduction without spreader grafts leading to collapse of upper lateral cartilages also known as inverted V deformity, as well as some degree of dorsal irregularities. An experienced revision rhinoplasty surgeon will not find it difficult to place spreader grafts and deal with smoothing your nasal dorsum. Five years has pasted since your primary surgery and you’re not still happy with the results, therefore a revision rhinoplasty is indicated.  Good luck. Dr. Kevin Sadati

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 224 reviews

Classic Inverted V shaped Deformity

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Hi.  Yes, I agree that this is an inverted V deformity.  I correct this with the use of spreader grafts and only cartilage grafts.  This is a fixable problem, but I would make sure that you see an experienced surgeon.

Jonathan Pontell, MD, FACS
Philadelphia Facial Plastic Surgeon
4.8 out of 5 stars 113 reviews

Inverted V deformity

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It looks like you have an inverted V deformity. The bumps can be smoothed as well as correcting the inverted V.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Unhappy with bridge after rhinoplasty

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I agree with you. The bridge, or dorsum, is irregular and has several issues. There is an inverted V deformity. This is basically an disproportion between the nasal bones and the middle third. It is probably worse on 3/4 view. The nasal bone on the left side of the nose seems wider than the right one. I think that these imperfections can be improved with a revision rhinoplasty. the result may not be perfect, but the nose should be much improved.

Andres Bustillo, MD, FACS
Miami Facial Plastic Surgeon
4.9 out of 5 stars 123 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.