BACKGROUND Various surgical techniques have been developed to enhance the nose shapes of Asian patients.Silicone implant augmentation rhinoplasty is widely used because it is relatively easy to perform and often yield...BACKGROUND Various surgical techniques have been developed to enhance the nose shapes of Asian patients.Silicone implant augmentation rhinoplasty is widely used because it is relatively easy to perform and often yields satisfactory outcomes.However,this technique may lead to complications,including ischemia,necrosis,and over-augmentation.The most appropriate management of these complications,including infection,is immediate implant removal and revision surgery once the accompanying inflammation has healed.Occasionally,the patient may experience distress from nasal deformities during the intervention period.CASE SUMMARY Herein,we describe the case of a patient who underwent a secondary dorsal augmentation,with a folded dermofat graft harvested from the inguinal area and simultaneous implant removal,successfully preventing dimpling of the nasal deformity.CONCLUSION This surgical method can effectively manage implant-related complications following augmentation rhinoplasty using a silicone implant and provide satis-factory patient outcomes.展开更多
Background:This study aimed to review treatments and evaluate the aesthetic outcomes,complications,and reoperation rates regarding surgical correction for a postoperative contracted nose.Methods:PubMed,MEDLINE,and Emb...Background:This study aimed to review treatments and evaluate the aesthetic outcomes,complications,and reoperation rates regarding surgical correction for a postoperative contracted nose.Methods:PubMed,MEDLINE,and Embase databases were searched for studies detailing aesthetic outcomes and complications of surgical correction of a contracted nose.Surgical procedures,adjuvant treatment,outcomes,and complications were synthesized and analyzed.Results:Nine articles encompassing 376 patients were included in the systematic review,and six articles(198 participants)were included in the meta-analysis.The most frequently used graft material was the autologous rib cartilage(61.1%).Surgical procedures were heterogeneous in these studies.The nasolabial angle reduced by 9.52°(95%confidence interval(CI):(-11.95,-7.09),P<0.0001),and the nasal length increased significantly(standardized mean difference(SMD)=2.25,95%CI:(1.26,2.23),P<0.00001).However,the evidence was insufficient to determine a significant change in the columellar-labial angle(SMD=-0.95,95%CI:(-2.19,0.29),P=0.13)and columellar-lobular angle(SMD=2.39,95%CI:(-1.20,5.97),P=0.19).Aesthetic dissatisfaction(12.5%)and infection(4.5%)were the most commonly reported complications.Reoperation was performed in 5.3%of patients.Conclusion:Surgical correction can increase the nasal length,reduce the nasolabial angle,and have a low reoperation rate.No significant improvement in the columellar-labial or columellar-lobular angle was observed.展开更多
The 3D simulation in preoperative design for nasal plastic surgery was studied to help patients see the postoperative effects and reduce medical disputes.The study developed and clinically tested an innovative design ...The 3D simulation in preoperative design for nasal plastic surgery was studied to help patients see the postoperative effects and reduce medical disputes.The study developed and clinically tested an innovative design for surgical guides for nasal plastic surgery,which showed positive results in patient satisfaction and accuracy in achieving the preoperative simulated effect.The study also investigated the process of designing and producing nasal prostheses and how patient feedback could be obtained using third-party social media voting.Patient satisfaction information was collected and evaluated using the Likert scale,and the data statistical analysis was carried out with the SPSS19.0 software.More than 94.1% of the patients were satisfied with the postoperative results.The study provides a good reference case for the integration of knowledge and skills from the medicine,design,and engineering fields in the development of medical devices.展开更多
Background: Over the years, an optimal surgical method for septorhinoplasty in deviated nose as a challenging problem was the one of common interest of plastic surgeon;the purpose of this study is to compare outcomes ...Background: Over the years, an optimal surgical method for septorhinoplasty in deviated nose as a challenging problem was the one of common interest of plastic surgeon;the purpose of this study is to compare outcomes of open and closed methods of septorhinoplasty in patients with deviated noses. Methods: Through a prospective study, we selected seventy patients with deviated nose. Based on their deviation severity, they underwent open or closed septorhinoplasty. Patients were evaluated for deviation angles of nasal bony and cartilage components, nasal projection, nasolabial angle, nasofacial angle, and nasofrontal angle;for which three standard photos were captured pre and postoperatively. Finally the outcomes were analyzed according to their surgical methods. Results: Closed septorhinoplasty could grant a mean 11 degrees correction to nasal bony component and a mean 8.6 degrees correction to cartilage component. That’s while open septorhinoplasty could bring a mean 19.5 degrees deviation correction to the bony component and a mean 12.5 degrees deviation correction to the cartilage component. Cosmetic angles were not improved significantly after the surgery, maybe because of complicated deformities our series of patients had. Conclusion: Open septorhinoplasty resulted in better cosmetic and functional outcomes than the closed method.展开更多
Background The corresponding author's experience and recent methods employed in autologous costal cartilage grafts combined with expanded polytetrafluoroethylene(ePTFE)in Asian rhinoplasty were presented in this s...Background The corresponding author's experience and recent methods employed in autologous costal cartilage grafts combined with expanded polytetrafluoroethylene(ePTFE)in Asian rhinoplasty were presented in this study.Objectives The purpose of this study was to assess the outcomes of rhinoplasty performed on patients using autogenous costal cartilage grafts combined with an ePTFE implant.Methods Seventy-five rhinoplasty cases with autologous costal cartilage grafts and an ePTFE implant were retrospectively reviewed.Graft types,complications associated with the graft itself or graft harvesting,surgical outcomes,and patient satisfaction were assessed.Results The mean follow-up time post-operation was 13.5 months.A total of 42/75 patients underwent revision surgeries.Graft-related complications were found in 8%of cases,including two warped graft and four infection cases.Three individuals with infections had mild graft resorption.One patient with an infection removed the implant.Graft exposure,mobility,and substantial resorption were not recorded.A total of two cases underwent revision procedures for infection and perforation,respectively.Chest incision lengths for graft harvesting averaged 2.1 cm.No pneumothorax or significant donor-site pain was found.Donor-site scars were negligible,although two cases had hypertrophic chest scars.In general,functional and esthetic outcomes were mostly satisfactory among the assessed patients.Conclusions Rhinoplasty using autologous rib cartilage provides adequate support and sufficient cartilage amounts for correcting nasal contouring.Meanwhile,ePTFE alone for nasal dorsum augmentation safely achieves satisfactory outcomes.Rib cartilage rhinoplasty performed by an experienced surgeon yields excellent,long-lasting results with minimal risk;however,the potential for infection should be considered following revision surgery.展开更多
BACKGROUND Thread rhinoplasty can trigger a reaction to thread material,which is a foreign body.We compared clinical features induced by absorbable and non-absorbable threads following thread rhinoplasty.CASE SUMMARY ...BACKGROUND Thread rhinoplasty can trigger a reaction to thread material,which is a foreign body.We compared clinical features induced by absorbable and non-absorbable threads following thread rhinoplasty.CASE SUMMARY Two patients who underwent different thread materials showed different clinical courses and different Hounsfield unit(HU)values in computed tomography.Patients with absorbable thread showed high HU values similar to a metallic material,and the HU value of inflammation was similar to vascular tissues with a lot of water(250).In the intraoperative field,absorbable thread materials and micro-abscesses were observed.In contrast,in the case of a non-absorbable thread,an object presumed to be thread was seen on the computed tomography(CT),and the HU value of inflammatory tissues was less than 100.In both patients,post-operative HU decreased to less than 100 and the clinical course improved.In both cases,histopathologic findings revealed foreign body granuloma associated with inflammation.CONCLUSION Absorbable threads were more aggressive and are more easily detected on CT.展开更多
This article is aimed to elaborate the significance of detecting clinical features (subjectivity, objectivity and assessment) of the Dysmorphophobic (DMP) psychiatric patients seeking primary cosmetic rhinoplsty (PCR)...This article is aimed to elaborate the significance of detecting clinical features (subjectivity, objectivity and assessment) of the Dysmorphophobic (DMP) psychiatric patients seeking primary cosmetic rhinoplsty (PCR). DMP clients present as a fixation of their thoughts toward the trivial flaws on their body’s anatomy. They consider such minor defects as major and show a great amount of anxiety for such negligible issues. Such dread affects their social, occupational and family’s life and trigger them to seek means of correcting such small blemishes through medical and or surgical approaches. Considering to their nose, they crave to eliminate their minor defects through PCR operation. PCR is viewed as one of the most prevalent aesthetic operations in the field of cosmetic surgery. Author’s method of approach in PCR is to select candidates after obtaining a meticulous health history, physical exam and appropriate para clinical tests. In some uncertained cases, based on their subjectivity and objectivity presentations, are referred for consultation with a psychiatrist for final assessment. Most selected patients undergo PCR via standby anesthesia through an incision on the nasal columella (open rhinoplasty), or in others which their nasal tip alternation is not needed, PCR is approached with no incision on the nasal columella (closed rhinoplasty). Due to the high demand of PCR in the world, among many clients who are seeking for such surgery, might be some cases with DMP disorder who are overlooked in spite of an accurate surgeon’s screening.展开更多
A review of the literature in commonly used retrieval systems generally yields minimal or no pertinent information on the early works of Chinese doctors.Herein,the early works in rhinoplasty by pioneers Dr.Maolian Hu...A review of the literature in commonly used retrieval systems generally yields minimal or no pertinent information on the early works of Chinese doctors.Herein,the early works in rhinoplasty by pioneers Dr.Maolian Hu(胡懋廉)and Dr.PC Nyi(倪葆春)were retrieved from the database of Chinese Medical Journal published before1949 that overseas doctors could not gain access to online possibly due to the language barrier in collecting and processing those old professional data by main retrieval systyems.They published original articles on costal cartilage applications for correction of saddle noses in as early as 1939 and 1949,respectively,which represent the earliest attempts of treating nasal deformities with costal cartilages in China as well as in Asia.The private cosmetic surgical practices in rhinoplasty from the 1930s to the 1940s were recovered and briefly reviewed,and some of the most important clinical cases were presented.Other important events related to rhinoplasty,such as the establishment of the first national society of rhinoplasty in Chengdu,China in 2011 and the successful performance of the first national congress on rhinoplasty in Shanghai,China in 2012,were included.展开更多
The aim of the current study was to investigate the gender differences in aesthetic rhinoplasty candidates in dimensions of psychopathology. Considering the existing body of literature, it was hypothesized that women ...The aim of the current study was to investigate the gender differences in aesthetic rhinoplasty candidates in dimensions of psychopathology. Considering the existing body of literature, it was hypothesized that women would score higher in different dimensions of psychopathology. SCL-90-R was used to evaluate the differences. This instrument consists of 10 subscales which measure depression, anxiety, phobia, hostility, obsessive-compulsive symptoms, interpersonal sensitivity, somatization, paranoid ideation, psychoticism, and added items of psychopathology. Independent t-test between male patients (n = 19) and female patients (n = 32) was performed. Findings indicated that women had higher scores in four subscales. Women had higher scores in anxiety (P < 0.01), obsessive-compulsive symptoms (P < 0.05), depression (P < 0.05), and added items (P < 0.05). Effect size measures were calculated in order for better interpretation of statistical significance tests. Findings supported the notion that women who applied for aesthetic rhinoplasty showed higher scores of anxiety, depression, obsessive-compulsive symptoms, and general psychopathological symptoms. Surgeons can utilize validated psychometric instruments in order to screen psychologically disturbed patients as these patients are more likely to show dissatisfaction after the surgery.展开更多
Introduction: The aim of this study is evaluation of chin deformities and their role in rhinoplasty cosmetic surgery outcomes via photogrammetry of chin. Materials and Methods: The study is a cross sectional one. All ...Introduction: The aim of this study is evaluation of chin deformities and their role in rhinoplasty cosmetic surgery outcomes via photogrammetry of chin. Materials and Methods: The study is a cross sectional one. All photos of rhinoplasty surgery candidates of three hospitals (Amir Aalam, Imam Khomeini and Razi of Tehran) which were taken in standard lateral position via SLR cameras were assessed through Adobe Photoshop CS, in order to determine four different aesthetic measurements. Except for excluded photos due to our excluding criteria or technical problems, all photographs were evaluated carefully. Results: 144 photos of patients were enrolled. The oldness of patients ranges between below 20 up to above;65.99 patients were female (68.8%) and 45 were male. 73 patients (50.7%) had an abnormal silver condition. Moreover 9 patients (6.3%) with abnormal nasomental, 124 patients with abnormal status of Gonzalez-Ulloa (93.8%), 63 patients (43.8%) with unusual status of Ricketts’ E line/upper and 49 patients (34%) with abnormal Ricketts’ E line/lower status can be demonstrated. Discussion: Performing a photogrammetric study for candidates of cosmetic rhinoplasty also a chin examination as a mandatory preoperative assessment seems to be essential. Due to the lack of studies in this field, more studies are necessary.展开更多
Rhinoplasty in Asia is becoming increasingly widespread.When taking into consideration the anatomical differences between the features of Caucasian and Asian patients,it is unsurprising that knowledge gained from rese...Rhinoplasty in Asia is becoming increasingly widespread.When taking into consideration the anatomical differences between the features of Caucasian and Asian patients,it is unsurprising that knowledge gained from research on Caucasian rhinoplasty is not always applicable to Asian rhinoplasty.Furthermore,reviews aimed at describing the recent developments in Asian rhinoplasty are rare.This review aims to provide a comprehensive summary of the latest trends in rhinoplasty for Asians by classifying it into three parts:methods,materials,and three-dimensional techniques,hopefully providing surgeons with references to aid in conducting rhinoplasty on Asians.展开更多
The selection of ideal posttraumatic augmentation rhinoplasty materials and technical strategies has always been a pressing challenge.Owing to the complexity of the traumatic nasal anatomical structure,such procedures...The selection of ideal posttraumatic augmentation rhinoplasty materials and technical strategies has always been a pressing challenge.Owing to the complexity of the traumatic nasal anatomical structure,such procedures are more complicated than ordinary cosmetic rhinoplasty.The choice of reconstruction material should emphasize its inherent characteristics,such as biocompatibility,anti-infective ability,strength,and plasticity.With the development of rhinoplasty,the choice of material is less limited and composite materials have become mainstream.This review outlines current composite materials and techniques in posttraumatic augmentation rhinoplasty.展开更多
<strong>Purpose:</strong> The timing, schedule, and doses of dexamethasone administration to control edema are a topic of debate. This prospective observational study was performed to evaluate the effects ...<strong>Purpose:</strong> The timing, schedule, and doses of dexamethasone administration to control edema are a topic of debate. This prospective observational study was performed to evaluate the effects of perioperative and intraoperative administration of dexamethasone on the occurrence of edema in patients who underwent rhinoplasty. <strong>Methods:</strong> This study was conducted at Najran University Hospital, Najran University, Saudi Arabia, from June 2019 to August 2020. Seventy-five patients who underwent open rhinoplasty were assigned using a consecutive non-random sampling method into three groups, with 25 patients in each group. Group A patients received three doses of intravenous 8 mg dexamethasone perioperatively, and group B patients received a single dose of intravenous 8 mg dexamethasone intraoperatively. Group C patients received intravenous 2 mL of 0.9% normal saline solution intraoperatively and were considered as a control group. Digital photographs of patients were obtained and assessed on the 1<sup>st</sup>, 7<sup>th</sup>, and 14<sup>th</sup> days post-operatively. <strong>Results:</strong> The mean duration of operation was comparable between the studied groups (p = 0.368). On comparing the studied groups, significant differences in the edema scores were observed on the 1<sup>st</sup> and 7<sup>th</sup> day post-operatively (p < 0.001 for both), but not on the 14<sup>th</sup> day (p = 0.079). When comparing each group against the postoperative day of evaluation, statistically significant differences were detected between the 1<sup>st</sup> vs. 7<sup>th</sup> day and 1<sup>st</sup> vs. 14<sup>th</sup> day in Group A, whereas, in the other groups, no significant difference was detected (all p > 0.05). No Dexamethasone-related complications were observed. <strong>Conclusion:</strong> Dexamethasone significantly reduced periorbital swelling and edema after rhinoplasty compared to the control group. A short course of triple dose perioperative administration of dexamethasone is more potent in reducing edema from 1<sup>st</sup> to 7<sup>th</sup> day postoperative than a single dose intraoperatively.展开更多
Interest in liquid,or nonsurgical rhinoplasty,has increased in demand as patients pursue less invasive techniques to achieve their aesthetic goals.Improved filler technology and refinement in injection techniques have...Interest in liquid,or nonsurgical rhinoplasty,has increased in demand as patients pursue less invasive techniques to achieve their aesthetic goals.Improved filler technology and refinement in injection techniques have made liquid rhinoplasty a reasonable choice for well-selected patients in both primary and revision rhinoplasty cases.This article reviews nasal anatomy,injection techniques,selected applications,and safety measures pertinent to performing nonsurgical rhinoplasty.展开更多
The aim of this paper is to discuss an updated technique for dorsal augmentation during rhinoplasty using diced cartilage wrapped in fascia. The usage of diced cartilage has been variously described in the literature ...The aim of this paper is to discuss an updated technique for dorsal augmentation during rhinoplasty using diced cartilage wrapped in fascia. The usage of diced cartilage has been variously described in the literature with consistently satisfactory results. Herein, we present our experience with patients undergoing dorsal augmentation during rhinoplasty using an updated method of diced cartilage wrapped in fascia. Diced cartilage fascia techniques have become the technique of choice for dorsal augmentation for an ever-increasing number of rhinoplasty surgeons. The term is broadly descriptive and there remains a wide-range of ways to execute. Updating and enhancing the technique with greater attention to precision, and creating an aesthetically optimal and predictable result, may result in even improved outcomes for future patients.展开更多
Aim:Self-esteem is one’s attitude towards oneself.It is one of the most important psychological aspects of rhinoplasty,a common aesthetic operation.Prior studies have indicated an improvement in patients’self-esteem...Aim:Self-esteem is one’s attitude towards oneself.It is one of the most important psychological aspects of rhinoplasty,a common aesthetic operation.Prior studies have indicated an improvement in patients’self-esteem after this operation.The aim of current study was to preoperatively compare self-esteem in patients seeking aesthetic rhinoplasty with that of functional rhinoplasty patients.Methods:A total of 42 patients completed the validated Rosenberg Self-Esteem Scale preoperatively(21 aesthetic surgery patients and 21 functional surgery patients).Those with both aesthetic and functional purposes were categorized regarding their primary objective.The t-test for independent groups was used for analysis of the data,and Cohen’s d was calculated as a measure of effect size.Results:The mean level of self-esteem in the aesthetic surgery group was significantly lower than that of the functional surgery group(P<0.05).Age,gender,socio-economic status,and educational backgrounds were analyzed and comparative analysis of each showed no significant difference between the two groups.The value of effect size measure was very high(d=1.04).Conclusion:The findings of the present study showed that aesthetic rhinoplasty patients had lower self-esteem in comparison with functional rhinoplasty patients.展开更多
On account of the poor biocompatibility of synthetic prosthesis,millions of rhinoplasty recipients have been forced to choose autologous costal cartilage as grafts,which suffer from limited availability,morbidity at t...On account of the poor biocompatibility of synthetic prosthesis,millions of rhinoplasty recipients have been forced to choose autologous costal cartilage as grafts,which suffer from limited availability,morbidity at the donor site and prolonged operation time.Here,as a promising alternative to autologous costal cartilage,we developed a novel xenogeneic costal cartilage and explored its feasibility as a rhinoplasty graft for the first time.Adopting an improved decellularization protocol,in which the ionic detergent was substituted by trypsin,the resulting decellularized graft was confirmed to preserve more structural components and better mechanics,and eliminate cellular components effectively.The in vitro and in vivo compatibility experiments demonstrated that the decellularized graft showed excellent biocompatibility and biosecurity.Additionally,the functionality assessment of rhinoplasty was performed in a rabbit model,and the condition of grafts after implantation was comprehensively evaluated.The optimized graft exhibited better capacity to reduce the degradation rate and maintain the morphology,in comparison to the decellularized costal cartilage prepared by conventional protocol.These findings indicate that this optimized graft derived from decellularized xenogeneic costal cartilage provides a new prospective for future investigations of rhinoplasty prosthesis and has great potential for clinical application.展开更多
Autologous costal cartilage is an excellent source of graft in rhinoplasty due to its rich supply,durability,versatility,and functionality.For a long time,rhinoplasty surgeons have been critical of using autologous co...Autologous costal cartilage is an excellent source of graft in rhinoplasty due to its rich supply,durability,versatility,and functionality.For a long time,rhinoplasty surgeons have been critical of using autologous costal cartilage based on the potential for associated complications including donor site morbidities,postoperative pain,warping,and long operation time.Even with this criticism,costal cartilage is still a gra昀material of choice in cartilage depleting revision rhinoplasty.Recently,there has been a steady increase in costal cartilage use even in primary augmentation rhinoplasty,especially in Asian.展开更多
A considerable part of revision rhinoplasty in Asians is associated with problems arising from the use of alloplastic implants. Revising alloplast associated problems of the nose mostly requires the use pf autogenous ...A considerable part of revision rhinoplasty in Asians is associated with problems arising from the use of alloplastic implants. Revising alloplast associated problems of the nose mostly requires the use pf autogenous grafting material to minimize complications and maximize favorable outcomes. Although remnant septal cartilage and/or conchal cartilage can be used, as the deformity becomes more severe, adequate revision requires more volume and strength of grafting materials. Autogenous rib cartilage may be the most practical choice in these circumstances. In this review, common causes of revision rhinoplasty in Asians are discussed together with operative techniques with emphasis on the use of autologous rib cartilage.展开更多
Rib cartilage is the most reliable material for structural support and dorsal augmentation in Asian rhinoplasty with its robust strength and bountiful amount. Its value is incomparable especially in complex, cartilage...Rib cartilage is the most reliable material for structural support and dorsal augmentation in Asian rhinoplasty with its robust strength and bountiful amount. Its value is incomparable especially in complex, cartilage-depleted revision surgery or major reconstruction. There are many articles regarding harvesting and carving of rib cartilage in rhinoplasty,however, only few has focused on preoperative and postoperative issues. Preoperatively, evaluating cartilage availability, assessing quality and quantity of cartilage, and choosing the cartilage to harvest are necessary. Although easily overlooked, proper postoperative management of rib cartilage rhinoplasty patients is key to prevent infection and heighten patient satisfaction. Here in, I would like to introduce how I evaluate rib cartilage rhinoplasty patients preoperatively and manage them postoperatively to maximize the surgical results.展开更多
文摘BACKGROUND Various surgical techniques have been developed to enhance the nose shapes of Asian patients.Silicone implant augmentation rhinoplasty is widely used because it is relatively easy to perform and often yields satisfactory outcomes.However,this technique may lead to complications,including ischemia,necrosis,and over-augmentation.The most appropriate management of these complications,including infection,is immediate implant removal and revision surgery once the accompanying inflammation has healed.Occasionally,the patient may experience distress from nasal deformities during the intervention period.CASE SUMMARY Herein,we describe the case of a patient who underwent a secondary dorsal augmentation,with a folded dermofat graft harvested from the inguinal area and simultaneous implant removal,successfully preventing dimpling of the nasal deformity.CONCLUSION This surgical method can effectively manage implant-related complications following augmentation rhinoplasty using a silicone implant and provide satis-factory patient outcomes.
基金supported by the Key Clinical Projects of Peking University Third Hospital(grant no.BYSYZD2019013)。
文摘Background:This study aimed to review treatments and evaluate the aesthetic outcomes,complications,and reoperation rates regarding surgical correction for a postoperative contracted nose.Methods:PubMed,MEDLINE,and Embase databases were searched for studies detailing aesthetic outcomes and complications of surgical correction of a contracted nose.Surgical procedures,adjuvant treatment,outcomes,and complications were synthesized and analyzed.Results:Nine articles encompassing 376 patients were included in the systematic review,and six articles(198 participants)were included in the meta-analysis.The most frequently used graft material was the autologous rib cartilage(61.1%).Surgical procedures were heterogeneous in these studies.The nasolabial angle reduced by 9.52°(95%confidence interval(CI):(-11.95,-7.09),P<0.0001),and the nasal length increased significantly(standardized mean difference(SMD)=2.25,95%CI:(1.26,2.23),P<0.00001).However,the evidence was insufficient to determine a significant change in the columellar-labial angle(SMD=-0.95,95%CI:(-2.19,0.29),P=0.13)and columellar-lobular angle(SMD=2.39,95%CI:(-1.20,5.97),P=0.19).Aesthetic dissatisfaction(12.5%)and infection(4.5%)were the most commonly reported complications.Reoperation was performed in 5.3%of patients.Conclusion:Surgical correction can increase the nasal length,reduce the nasolabial angle,and have a low reoperation rate.No significant improvement in the columellar-labial or columellar-lobular angle was observed.
文摘The 3D simulation in preoperative design for nasal plastic surgery was studied to help patients see the postoperative effects and reduce medical disputes.The study developed and clinically tested an innovative design for surgical guides for nasal plastic surgery,which showed positive results in patient satisfaction and accuracy in achieving the preoperative simulated effect.The study also investigated the process of designing and producing nasal prostheses and how patient feedback could be obtained using third-party social media voting.Patient satisfaction information was collected and evaluated using the Likert scale,and the data statistical analysis was carried out with the SPSS19.0 software.More than 94.1% of the patients were satisfied with the postoperative results.The study provides a good reference case for the integration of knowledge and skills from the medicine,design,and engineering fields in the development of medical devices.
文摘Background: Over the years, an optimal surgical method for septorhinoplasty in deviated nose as a challenging problem was the one of common interest of plastic surgeon;the purpose of this study is to compare outcomes of open and closed methods of septorhinoplasty in patients with deviated noses. Methods: Through a prospective study, we selected seventy patients with deviated nose. Based on their deviation severity, they underwent open or closed septorhinoplasty. Patients were evaluated for deviation angles of nasal bony and cartilage components, nasal projection, nasolabial angle, nasofacial angle, and nasofrontal angle;for which three standard photos were captured pre and postoperatively. Finally the outcomes were analyzed according to their surgical methods. Results: Closed septorhinoplasty could grant a mean 11 degrees correction to nasal bony component and a mean 8.6 degrees correction to cartilage component. That’s while open septorhinoplasty could bring a mean 19.5 degrees deviation correction to the bony component and a mean 12.5 degrees deviation correction to the cartilage component. Cosmetic angles were not improved significantly after the surgery, maybe because of complicated deformities our series of patients had. Conclusion: Open septorhinoplasty resulted in better cosmetic and functional outcomes than the closed method.
基金This work was supported by Key Clinical Projects of Peking University Third Hospital(No.BYSYZD2019013)the Scientific Research Staring Foundation for the Returned Overseas Chinese Scholars,Peking University Third Hospital(No.BYSYLXHG2019001).
文摘Background The corresponding author's experience and recent methods employed in autologous costal cartilage grafts combined with expanded polytetrafluoroethylene(ePTFE)in Asian rhinoplasty were presented in this study.Objectives The purpose of this study was to assess the outcomes of rhinoplasty performed on patients using autogenous costal cartilage grafts combined with an ePTFE implant.Methods Seventy-five rhinoplasty cases with autologous costal cartilage grafts and an ePTFE implant were retrospectively reviewed.Graft types,complications associated with the graft itself or graft harvesting,surgical outcomes,and patient satisfaction were assessed.Results The mean follow-up time post-operation was 13.5 months.A total of 42/75 patients underwent revision surgeries.Graft-related complications were found in 8%of cases,including two warped graft and four infection cases.Three individuals with infections had mild graft resorption.One patient with an infection removed the implant.Graft exposure,mobility,and substantial resorption were not recorded.A total of two cases underwent revision procedures for infection and perforation,respectively.Chest incision lengths for graft harvesting averaged 2.1 cm.No pneumothorax or significant donor-site pain was found.Donor-site scars were negligible,although two cases had hypertrophic chest scars.In general,functional and esthetic outcomes were mostly satisfactory among the assessed patients.Conclusions Rhinoplasty using autologous rib cartilage provides adequate support and sufficient cartilage amounts for correcting nasal contouring.Meanwhile,ePTFE alone for nasal dorsum augmentation safely achieves satisfactory outcomes.Rib cartilage rhinoplasty performed by an experienced surgeon yields excellent,long-lasting results with minimal risk;however,the potential for infection should be considered following revision surgery.
基金Supported by the National Research Foundation of Korea grant funded by the Korea government(MSIT),No.2021R1G1A1008337the Soonchunhyang University Research Fund.
文摘BACKGROUND Thread rhinoplasty can trigger a reaction to thread material,which is a foreign body.We compared clinical features induced by absorbable and non-absorbable threads following thread rhinoplasty.CASE SUMMARY Two patients who underwent different thread materials showed different clinical courses and different Hounsfield unit(HU)values in computed tomography.Patients with absorbable thread showed high HU values similar to a metallic material,and the HU value of inflammation was similar to vascular tissues with a lot of water(250).In the intraoperative field,absorbable thread materials and micro-abscesses were observed.In contrast,in the case of a non-absorbable thread,an object presumed to be thread was seen on the computed tomography(CT),and the HU value of inflammatory tissues was less than 100.In both patients,post-operative HU decreased to less than 100 and the clinical course improved.In both cases,histopathologic findings revealed foreign body granuloma associated with inflammation.CONCLUSION Absorbable threads were more aggressive and are more easily detected on CT.
文摘This article is aimed to elaborate the significance of detecting clinical features (subjectivity, objectivity and assessment) of the Dysmorphophobic (DMP) psychiatric patients seeking primary cosmetic rhinoplsty (PCR). DMP clients present as a fixation of their thoughts toward the trivial flaws on their body’s anatomy. They consider such minor defects as major and show a great amount of anxiety for such negligible issues. Such dread affects their social, occupational and family’s life and trigger them to seek means of correcting such small blemishes through medical and or surgical approaches. Considering to their nose, they crave to eliminate their minor defects through PCR operation. PCR is viewed as one of the most prevalent aesthetic operations in the field of cosmetic surgery. Author’s method of approach in PCR is to select candidates after obtaining a meticulous health history, physical exam and appropriate para clinical tests. In some uncertained cases, based on their subjectivity and objectivity presentations, are referred for consultation with a psychiatrist for final assessment. Most selected patients undergo PCR via standby anesthesia through an incision on the nasal columella (open rhinoplasty), or in others which their nasal tip alternation is not needed, PCR is approached with no incision on the nasal columella (closed rhinoplasty). Due to the high demand of PCR in the world, among many clients who are seeking for such surgery, might be some cases with DMP disorder who are overlooked in spite of an accurate surgeon’s screening.
文摘A review of the literature in commonly used retrieval systems generally yields minimal or no pertinent information on the early works of Chinese doctors.Herein,the early works in rhinoplasty by pioneers Dr.Maolian Hu(胡懋廉)and Dr.PC Nyi(倪葆春)were retrieved from the database of Chinese Medical Journal published before1949 that overseas doctors could not gain access to online possibly due to the language barrier in collecting and processing those old professional data by main retrieval systyems.They published original articles on costal cartilage applications for correction of saddle noses in as early as 1939 and 1949,respectively,which represent the earliest attempts of treating nasal deformities with costal cartilages in China as well as in Asia.The private cosmetic surgical practices in rhinoplasty from the 1930s to the 1940s were recovered and briefly reviewed,and some of the most important clinical cases were presented.Other important events related to rhinoplasty,such as the establishment of the first national society of rhinoplasty in Chengdu,China in 2011 and the successful performance of the first national congress on rhinoplasty in Shanghai,China in 2012,were included.
文摘The aim of the current study was to investigate the gender differences in aesthetic rhinoplasty candidates in dimensions of psychopathology. Considering the existing body of literature, it was hypothesized that women would score higher in different dimensions of psychopathology. SCL-90-R was used to evaluate the differences. This instrument consists of 10 subscales which measure depression, anxiety, phobia, hostility, obsessive-compulsive symptoms, interpersonal sensitivity, somatization, paranoid ideation, psychoticism, and added items of psychopathology. Independent t-test between male patients (n = 19) and female patients (n = 32) was performed. Findings indicated that women had higher scores in four subscales. Women had higher scores in anxiety (P < 0.01), obsessive-compulsive symptoms (P < 0.05), depression (P < 0.05), and added items (P < 0.05). Effect size measures were calculated in order for better interpretation of statistical significance tests. Findings supported the notion that women who applied for aesthetic rhinoplasty showed higher scores of anxiety, depression, obsessive-compulsive symptoms, and general psychopathological symptoms. Surgeons can utilize validated psychometric instruments in order to screen psychologically disturbed patients as these patients are more likely to show dissatisfaction after the surgery.
文摘Introduction: The aim of this study is evaluation of chin deformities and their role in rhinoplasty cosmetic surgery outcomes via photogrammetry of chin. Materials and Methods: The study is a cross sectional one. All photos of rhinoplasty surgery candidates of three hospitals (Amir Aalam, Imam Khomeini and Razi of Tehran) which were taken in standard lateral position via SLR cameras were assessed through Adobe Photoshop CS, in order to determine four different aesthetic measurements. Except for excluded photos due to our excluding criteria or technical problems, all photographs were evaluated carefully. Results: 144 photos of patients were enrolled. The oldness of patients ranges between below 20 up to above;65.99 patients were female (68.8%) and 45 were male. 73 patients (50.7%) had an abnormal silver condition. Moreover 9 patients (6.3%) with abnormal nasomental, 124 patients with abnormal status of Gonzalez-Ulloa (93.8%), 63 patients (43.8%) with unusual status of Ricketts’ E line/upper and 49 patients (34%) with abnormal Ricketts’ E line/lower status can be demonstrated. Discussion: Performing a photogrammetric study for candidates of cosmetic rhinoplasty also a chin examination as a mandatory preoperative assessment seems to be essential. Due to the lack of studies in this field, more studies are necessary.
基金the Key Clinical Projects of Peking University Third Hospital(grant no.BYSYFY2021005).
文摘Rhinoplasty in Asia is becoming increasingly widespread.When taking into consideration the anatomical differences between the features of Caucasian and Asian patients,it is unsurprising that knowledge gained from research on Caucasian rhinoplasty is not always applicable to Asian rhinoplasty.Furthermore,reviews aimed at describing the recent developments in Asian rhinoplasty are rare.This review aims to provide a comprehensive summary of the latest trends in rhinoplasty for Asians by classifying it into three parts:methods,materials,and three-dimensional techniques,hopefully providing surgeons with references to aid in conducting rhinoplasty on Asians.
文摘The selection of ideal posttraumatic augmentation rhinoplasty materials and technical strategies has always been a pressing challenge.Owing to the complexity of the traumatic nasal anatomical structure,such procedures are more complicated than ordinary cosmetic rhinoplasty.The choice of reconstruction material should emphasize its inherent characteristics,such as biocompatibility,anti-infective ability,strength,and plasticity.With the development of rhinoplasty,the choice of material is less limited and composite materials have become mainstream.This review outlines current composite materials and techniques in posttraumatic augmentation rhinoplasty.
文摘<strong>Purpose:</strong> The timing, schedule, and doses of dexamethasone administration to control edema are a topic of debate. This prospective observational study was performed to evaluate the effects of perioperative and intraoperative administration of dexamethasone on the occurrence of edema in patients who underwent rhinoplasty. <strong>Methods:</strong> This study was conducted at Najran University Hospital, Najran University, Saudi Arabia, from June 2019 to August 2020. Seventy-five patients who underwent open rhinoplasty were assigned using a consecutive non-random sampling method into three groups, with 25 patients in each group. Group A patients received three doses of intravenous 8 mg dexamethasone perioperatively, and group B patients received a single dose of intravenous 8 mg dexamethasone intraoperatively. Group C patients received intravenous 2 mL of 0.9% normal saline solution intraoperatively and were considered as a control group. Digital photographs of patients were obtained and assessed on the 1<sup>st</sup>, 7<sup>th</sup>, and 14<sup>th</sup> days post-operatively. <strong>Results:</strong> The mean duration of operation was comparable between the studied groups (p = 0.368). On comparing the studied groups, significant differences in the edema scores were observed on the 1<sup>st</sup> and 7<sup>th</sup> day post-operatively (p < 0.001 for both), but not on the 14<sup>th</sup> day (p = 0.079). When comparing each group against the postoperative day of evaluation, statistically significant differences were detected between the 1<sup>st</sup> vs. 7<sup>th</sup> day and 1<sup>st</sup> vs. 14<sup>th</sup> day in Group A, whereas, in the other groups, no significant difference was detected (all p > 0.05). No Dexamethasone-related complications were observed. <strong>Conclusion:</strong> Dexamethasone significantly reduced periorbital swelling and edema after rhinoplasty compared to the control group. A short course of triple dose perioperative administration of dexamethasone is more potent in reducing edema from 1<sup>st</sup> to 7<sup>th</sup> day postoperative than a single dose intraoperatively.
文摘Interest in liquid,or nonsurgical rhinoplasty,has increased in demand as patients pursue less invasive techniques to achieve their aesthetic goals.Improved filler technology and refinement in injection techniques have made liquid rhinoplasty a reasonable choice for well-selected patients in both primary and revision rhinoplasty cases.This article reviews nasal anatomy,injection techniques,selected applications,and safety measures pertinent to performing nonsurgical rhinoplasty.
文摘The aim of this paper is to discuss an updated technique for dorsal augmentation during rhinoplasty using diced cartilage wrapped in fascia. The usage of diced cartilage has been variously described in the literature with consistently satisfactory results. Herein, we present our experience with patients undergoing dorsal augmentation during rhinoplasty using an updated method of diced cartilage wrapped in fascia. Diced cartilage fascia techniques have become the technique of choice for dorsal augmentation for an ever-increasing number of rhinoplasty surgeons. The term is broadly descriptive and there remains a wide-range of ways to execute. Updating and enhancing the technique with greater attention to precision, and creating an aesthetically optimal and predictable result, may result in even improved outcomes for future patients.
文摘Aim:Self-esteem is one’s attitude towards oneself.It is one of the most important psychological aspects of rhinoplasty,a common aesthetic operation.Prior studies have indicated an improvement in patients’self-esteem after this operation.The aim of current study was to preoperatively compare self-esteem in patients seeking aesthetic rhinoplasty with that of functional rhinoplasty patients.Methods:A total of 42 patients completed the validated Rosenberg Self-Esteem Scale preoperatively(21 aesthetic surgery patients and 21 functional surgery patients).Those with both aesthetic and functional purposes were categorized regarding their primary objective.The t-test for independent groups was used for analysis of the data,and Cohen’s d was calculated as a measure of effect size.Results:The mean level of self-esteem in the aesthetic surgery group was significantly lower than that of the functional surgery group(P<0.05).Age,gender,socio-economic status,and educational backgrounds were analyzed and comparative analysis of each showed no significant difference between the two groups.The value of effect size measure was very high(d=1.04).Conclusion:The findings of the present study showed that aesthetic rhinoplasty patients had lower self-esteem in comparison with functional rhinoplasty patients.
基金supported by Sichuan Science and Technology Program(2020YFH0008)National Natural Science Foundation of China(No.81771351)+1 种基金Joint Research Fund Liaoning-Shenyang National Laboratory for Materials Science(2019JH3/30100022)National Key R&D Program of China(2017YFA0105802).
文摘On account of the poor biocompatibility of synthetic prosthesis,millions of rhinoplasty recipients have been forced to choose autologous costal cartilage as grafts,which suffer from limited availability,morbidity at the donor site and prolonged operation time.Here,as a promising alternative to autologous costal cartilage,we developed a novel xenogeneic costal cartilage and explored its feasibility as a rhinoplasty graft for the first time.Adopting an improved decellularization protocol,in which the ionic detergent was substituted by trypsin,the resulting decellularized graft was confirmed to preserve more structural components and better mechanics,and eliminate cellular components effectively.The in vitro and in vivo compatibility experiments demonstrated that the decellularized graft showed excellent biocompatibility and biosecurity.Additionally,the functionality assessment of rhinoplasty was performed in a rabbit model,and the condition of grafts after implantation was comprehensively evaluated.The optimized graft exhibited better capacity to reduce the degradation rate and maintain the morphology,in comparison to the decellularized costal cartilage prepared by conventional protocol.These findings indicate that this optimized graft derived from decellularized xenogeneic costal cartilage provides a new prospective for future investigations of rhinoplasty prosthesis and has great potential for clinical application.
文摘Autologous costal cartilage is an excellent source of graft in rhinoplasty due to its rich supply,durability,versatility,and functionality.For a long time,rhinoplasty surgeons have been critical of using autologous costal cartilage based on the potential for associated complications including donor site morbidities,postoperative pain,warping,and long operation time.Even with this criticism,costal cartilage is still a gra昀material of choice in cartilage depleting revision rhinoplasty.Recently,there has been a steady increase in costal cartilage use even in primary augmentation rhinoplasty,especially in Asian.
文摘A considerable part of revision rhinoplasty in Asians is associated with problems arising from the use of alloplastic implants. Revising alloplast associated problems of the nose mostly requires the use pf autogenous grafting material to minimize complications and maximize favorable outcomes. Although remnant septal cartilage and/or conchal cartilage can be used, as the deformity becomes more severe, adequate revision requires more volume and strength of grafting materials. Autogenous rib cartilage may be the most practical choice in these circumstances. In this review, common causes of revision rhinoplasty in Asians are discussed together with operative techniques with emphasis on the use of autologous rib cartilage.
文摘Rib cartilage is the most reliable material for structural support and dorsal augmentation in Asian rhinoplasty with its robust strength and bountiful amount. Its value is incomparable especially in complex, cartilage-depleted revision surgery or major reconstruction. There are many articles regarding harvesting and carving of rib cartilage in rhinoplasty,however, only few has focused on preoperative and postoperative issues. Preoperatively, evaluating cartilage availability, assessing quality and quantity of cartilage, and choosing the cartilage to harvest are necessary. Although easily overlooked, proper postoperative management of rib cartilage rhinoplasty patients is key to prevent infection and heighten patient satisfaction. Here in, I would like to introduce how I evaluate rib cartilage rhinoplasty patients preoperatively and manage them postoperatively to maximize the surgical results.
