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Deformations in a Transverse Cross Section

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Inverted-V Deformity: An Anatomic Study.

Lennert Minelli¹, Peter P Callan

¹Melbourne Advanced Facial Anatomy Course (MAFAC) of the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), Toorak, Victoria, Australia.

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|August 5, 2022

Summary

This summary is machine-generated.

The inverted-V deformity in rhinoplasty occurs when upper lateral cartilages (ULCs) detach after dorsal hump resection. Applying caudal traction to the ULCs during reconstruction can prevent this complication by re-tensioning their dynamic attachment to the nasal bones.

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Area of Science:

Plastic Surgery
Anatomy
Rhinology

Background:

The inverted-V deformity is a common aesthetic issue following dorsal hump resection in rhinoplasty.
Upper lateral cartilages (ULCs) can detach from nasal bones after surgery, creating an undesirable step-off deformity.

Purpose of the Study:

To investigate the mechanism behind ULC separation from nasal bones after dorsal hump resection.
To understand and identify methods for preventing the inverted-V deformity.

Main Methods:

Anatomic dissection was performed on 12 fresh cadavers.
Dorsal hump resection (bony and cartilaginous) was conducted to observe effects on ULCs.
Preventative maneuvers were assessed in a secondary study.

Main Results:

Cartilaginous dorsal resection disrupts the T-frame's spreader mechanism, destabilizing ULCs.
ULCs become free-floating and migrate posteriorly, medially, and cranially, leading to separation from nasal bones.
Caudal traction on ULCs effectively re-tensions their dynamic attachments to the nasal bones.

Conclusions:

The attachment between the nasal dorsum and ULCs is dynamic, not static.
Applying caudal traction to ULCs during dorsal reconstruction in primary rhinoplasty can prevent inverted-V deformity by securing ULCs to the nasal bones.