An inverted-V deformity usually occurs after rhinoplasty when the upper lateral cartilages (middle-third of the nose) separate from the dorsal septum (bridge) and collapse. This collapse in the middle third of the nose manifests as a visible step-off in the transition between the nasal bones of the upper third of the nose and the upper lateral cartilages in the middle third of the nose. The shape of the visible nasal bones is an upside-down, or “inverted” V.
The reason the inverted-V deformity after rhinoplasty is so problematic is that not only does it result in an obvious cosmetic deformity, the upper lateral cartilages are an important part of the nasal valve. Collapse of the nasal valve results in significant functional issues with nasal obstruction. It’s an area that commonly needs to be addressed in revision rhinoplasty.
How is the inverted-V deformity avoided during rhinoplasty? During rhinoplasty, when a dorsal hump is removed, care must be taken to reconstruct the nasal valve by reattaching the upper lateral cartilages to the septum +/- spreader grafts (pieces of cartilage used to widen the nasal valve).
