V-deformity? Second Revision? (photo)

Rhinoplasty 26 months ago, removal of a dorsal hump, tip refinement. Now: V deformity on the right. I feel a space between the right nasal bone and the septum. I see a concavity on the right side of the body/tip of the nose. Septum deviation remains which the surgeon advised me not to have corrected; manipulation of the ala cartilages would be sufficient to achieve symmetry. I am not very satisfied with the overall result. Any way for me to have the above issues corrected?

Doctor Answers 7

Correcting V-deformity

A unilateral depression and V deformity is best treated with a spreader graft harvested from the septum during the septoplasty procedure.  If symptomatic, a septoplasty to repair a deviated septum can also be performed and a small piece of cartilage can be harvested from the septum inserted into the area of the left upper lateral cartilage that is creating the V deformity.  Additional onlay grafts can also be performed if needed.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Revision rhinoplasty

Yes its possible to improve these problems with further surgery.Often a slim straight piece of septal cartillage can be inserted between the sidewall and the septum to move it outward. This is commonly referred to as a "Spreader Graft" This may be a good opertunity to have your septum corrected as well.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 108 reviews

Revision rhinoplasty question

Dear Jens82959,

  • In short, a revision rhinoplasty can address all of your concerns
  • A graft on the right side would improve the look by fixing the concavity
  • For the alar cartilages, an in person exam would be necessary as the pictures a little unclear

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

Inverted V Deformity after Rhinoplasty

It is difficult to see the inverted-V deformity in these pictures but this can occur secondary to collapse of the middle portion of the nose. However, all the problems you describe can be corrected , preferably by a surgeon who specializes in revision rhinoplasty. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Inverted V deformity

A spreader graft can be used to correct the concavity/inverted V deformity you're noticing on the right side of your nose.

This type of narrowing can occur after hump reduction if adequate support isn't given to the upper lateral cartilage after surgery.

You can learn more about spreader graft placement at my web reference link below.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Inverted-V deformity after dorsal hump removal

Your issue certainly can be corrected.  Unfortunately, inverted-V deformities can occur dorsal hump reduction.  Placing a cartilage graft on the ride side of your nose called a spreader graft would help to eliminate the concavity and improve the symmetry of your nose.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 58 reviews

?V-deformity of nose

Thanks for the photos but it is a bit difficult to see the deformity. If you do have a "V" deformity this may be due to mid vault collapse and can be treated..

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 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.