Bone Defects

Secondary rhinoplasty for inverted V deformity and residual deviation, by Dr. Gerbault:

• The so-called inverted V deformities are a frequent complication of "classic" rhinoplasty which consists of removing a hump by breaking the bones and cutting the cartilage. The lack of reconstruction of the new dorsum leads not only to these deformities with a significant demarcation between bones and cartilages, but also to respiratory problems related to the dorsum pinching.
• In this case, a residual deviation of the nasal septum was existing. The correction of these problems involves a reconstruction of the dorsum thanks to grafts positioned as beams (spreader grafts) often associated with a cover by an aponevrosis to smooth the new dorsum. The septum was of course put back straight on this occasion. These grafts open the pinched space to help breathe better.
• Finally, in this case, the nose was smoothed by ultrasonic rhinoplasty and the tip reshaped by sutures on the cartilages and a good tip support.
• The result is shown one year after the operation.

Secondary Ethnic Rhinoplasty

• Iranian patient already operated for a hump and a broad tip.
• Persistence of 2 problems with inverted V deformity.
• Persistent septal deviation.
• Secondary rhinoplasty with ultrasonic rhinosculpture.
• Spreader grafts and rebuilding of the architecture of the nasal pyramid.
• Result at 1 year.