How Best To Correct Wide Nose and Visible V Line 14 Months Post Op? (photo)

I had rhinoplasty 14 mnths ago to remove hump on my nose,septoplasty and tip shortened, but my nose is wider now and I have visible line as inverted v where my bone meet uper cardilage, which is not nice aesteticly at all. I still tapping my nose during the night and day and it look better then just for few hours. At it seems less dent after tapping between tip and end of the bone. My doctor did osteotomis, but he said he left bones bit wider because to improve my breathing and profile what now?

Doctor Answers 4

Wide nose and inverted V appearance after rhinoplasty

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It looks like your increased nose width is from an open roof deformity. This results when the nasal bones aren't brought in after removing a bump from the bridge. It sounds like your surgeon did osteotomies to bring in the bone but for some reason there's still excess width.

Repeat osteotomies can be done to bring the bone in toward each other and narrow the appearance of your nose. Spreader grafts may needed to be placed to support the middle third of your nose in the area of the inverted V and internal nasal valves. My link below describes what spreader grafts are in more detail.

Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Revision rhinoplasty to correct wide nose & inverted V deformity

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It is certainly acceptable to undergo a revision rhinoplasty 14 months after the primary procedure.  The inverted V deformity is best treated with a combination of either osteotomies and/or spreader grafts.  Spreader grafts are harvested from the septal cartilage and if there is no septal cartilage present then ear cartilage can be substituted.  This usually corrects the inverted V.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Improve nasal Appearance and Function with Revision Rhinoplasty

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 With a revision I would repeat your unsuccessful osteotomies to narrow the nasal bones which will not impair nasal breathing. You do have the inverted V deformity which can be corrected with cartilage grafts to improve the appearance of the narrow mid-portion of the nose and nasal breathing. I would also place a cartilage graft   to increase tip projection and improve definition.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Sometimes people need revision rhinoplasty to both re-narrow the nasal bones and support a narrow valve below

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Sometimes even with osteotomies (breaking the bones) the nasal bones widen again. This can be corrected with more aggressive osteotomies such as medial fading osteotomies or horizontal osteotomies in addition the standard lateral types.
Narrowing below the bones in the middle third of the nose is called an "inverted V" deformity. This can be corrected by the use of grafts of your own cartilage. Two options are called spreader grafts or butterfly grafts. You should discuss this with a revsion rhinoplasty specialist to determine what will work best for you.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 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.