What is ‘open roof deformity’ in reference to a rhinoplasty? How can this be avoided or fixed?

An open roof deformity is a term used to describe the appearance of the nose after a large dorsal hump reduction. When a large dorsal hump is reduced, the bridge/dorsum of the nose appears flat…this is an open roof deformity. At the time of rhinoplasty, osteotomies will re-position the nasal bones in such a way as to close the open roof and achieve a result that is natural in appearance. Patients who have a large dorsal hump that is reduced and then have osteotomies to close an open roof are at risk for narrowing of the mid-portion of the nose. This is prevented by the placement of spreader grafts.