Inverted-V Deformity: An Anatomical Study.

This anatomical dissection study has established that the connection between the nasal dorsum and ULCs is not a static fusion but is dynamic. This important finding explains why cartilaginous dorsum resection with removal of the T-frame results in recoil of the ULCs despite their attachment to the nasal bones, causing an inverted-V deformity. Based on this understanding, it is advised to apply caudal traction to restore the anatomical position of the ULCs when reconstructing the dorsum in primary rhinoplasty, irrespective of the method used. This will tension the ULCs towards the nasal bones eliminating the inverted-V deformity by utilizing the intrinsic bony-cartilaginous attachments.