Procedure: Secondary Septorhinoplasty with deep temporalis fascia and conchal cartilage harvest, platelet gel application. A columellar strut, spreader grafts and osteotomies were performed.

FINDINGS: 7 mm intact lower lateral cartilages (LLC), narrow left greater than right middle vault with open roof deformity and splayed left nasal bone, over-resected mid-cartilaginous dorsum, over-rotated infratip lobule, residual bony dorsal hump, over-projected tip with medial crural overlay of 2mm. Caudal septum deviated to left and large posterior left spur.

Comment: AFter 6 months, her severe inverted V deformity is resolved.

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