Inverted V Deformity

The inverted V deformity is most common in patients who have undergone previous
rhinoplasty surgery. Patients with this problem will have nasal airway obstruction and dorsal nasal deformity. Surgical correction may be performed to improve the shape and the nasal airway.


The inverted V deformity is seen on external nasal exam. The inverted V appears with the apex at the junction of the dorsal septum and nasal bones. The limbs of the V extend inferiorly and laterally over the upper lateral cartilages. The internal nasal exam reveals a narrow and collapsed internal nasal valve.


Surgical correction of the inverted V deformity may involve a few procedures. Spreader grafts are placed between the dorsal septum and upper lateral cartilages in order to open the internal nasal valve. The grafts will also improve the appearance of the inverted V. Osteotomies may be performed in some cases. Osteotomies are cuts made through the nasal bones, and these cuts allow for repositioning of the bones. In cases where a dorsal hump was removed but the nasal bones were not repositioned to close an open roof deformity, osteotomies may help improve an inverted V deformity. In addition, dorsal grafting may improve the shape and contour irregularities associated with an inverted V deformity.

Do you have any questions regarding the inverted V defomity or any other questions regarding rhinoplasty? Call Dr. David Bray’s office–we’d be happy to answer any of your questions. Schedule a consultation today!

Before/after images of Dr Bray, Jr.’s rhinoplasty work are in the image gallery.