Generally speaking, rhinoplasty can be divided into three types: common rhinoplasty, compound rhinoplasty and comprehensive rhinoplasty. If the subdivision can be the shaping of nasal root, nasal dorsum, nasal tip, nasal columella, alar, nostril, nasal floor, frontal nasal angle, nasal olive and other nasal subunits. Considering that it is difficult for ordinary beauty seekers to understand more in-depth professional knowledge, in this article, I still divide the nose into two parts-the back of the nose and the nose.
Nasal dorsoplasty
Raising the height of the nose is the most common requirement for rhinoplasty for yellow people.
In traditional rhinoplasty, L-shaped nose prosthesis is often used to lift the back of nose and the tip of nose at the same time, but in recent five years, the trend is to use I-shaped prosthesis to simply enlarge the back of nose instead of the previous L-shaped prosthesis. The root cause behind this evolution will be explained in detail below. In addition to artificial materials, autologous cartilage is often used to cushion the bridge of the nose. In European and American countries, autologous cartilage is basically used to replace artificial materials to pad the bridge of the nose, because the characteristics of Europeans and Americans determine that it is desirable for them to have a large number of nasal septal cartilage; The anatomical characteristics of the oriental nose determine that we can't be so willful. The bone mass of the oriental nasal septum may not be enough as a supporting rod for lifting the nose, let alone padding the bridge of the nose. Therefore, if the beauty seeker really can't accept artificial materials, then he has to do another operation to remove costal cartilage. The artificial materials used in rhinoplasty, such as silicone prosthesis, swelling and autogenous cartilage, have their own advantages and disadvantages. Let me explain briefly below.
1. silicone prosthesis
The most traditional L-shaped silicone prosthesis has been basically eliminated now. This most traditional prosthesis is similar in appearance to the current three-stage prosthesis, but the material used for the nose augmentation head and nose column is as hard as the material used for the back of the nose.
Due to gravity and skin tension, the use of silicone prosthesis at the tip of the nose may lead to skin rupture at the tip of the nose. In order to avoid this shortcoming of L-shaped silicone prosthesis, plastic surgeons and prosthesis manufacturers have adopted increasingly soft materials (especially the tip of nose), which are now popular one-stage, two-stage and three-stage silicone prostheses.
If you have the opportunity to contact this prosthesis, you can feel that the materials of the back of the nose and the tip of the nose are different. But is this improvement really effective? Through simple logical reasoning, it can be seen that if the effect is really good, plastic surgeons now will not generally advocate not taking a vacation at the nose.
Advantages and disadvantages of silicone prosthesis
Advantages of silicone prosthesis: good physical and chemical stability and physical inertia, long-term placement in the body, resistance to tissue fluid corrosion, non-absorption and degradation by metabolism, hydrophobicity, heat resistance, good blood and tissue compatibility and good plasticity. Its clinical application has good biocompatibility and biological stability, and it is easy to carve and take out completely once complications occur. Implantable silicone rubber is not absorbed by tissues, and it is elastic, moderate in hardness, not easy to bend and deform, low in price and widely used in clinic.
Disadvantages of silicone prosthesis: light transmission, easy sliding and slightly hard texture. Clinically, the prosthesis often floats, shakes, falls off, skews, and may even rupture the skin and expose it, as well as complications such as contracture of the prosthesis capsule, infection and prominent nasal tip contour. The main disadvantages of silicone prosthesis are that it is easy to slide, deform and twist in the later stage, and the damaged parts of skin are easy to wear and tear, which is difficult to overcome.
Based on these characteristics, in recent years, the size and length of silicone nose prosthesis used in bed are getting smaller and smaller. If the nasal tip needs to be reshaped at the same time, autologous cartilage transplantation is often used to reshape the nasal tip alone. Personally, I think that the effect of just using "I" prosthesis to pad the bridge of the nose may not be as natural as swelling, but it can still satisfy most plastic surgeons and beauty seekers. In addition, with the "L" prosthesis for rhinoplasty, the activity of the nose tip is very poor, and it is basically impossible to do the "pig nose" action. However, if the nose is padded with "I" prosthesis and the tip of the nose is shaped with autologous cartilage, the activity of the tip of the nose is almost the same as that of a normal nose. In particular, women who have had rhinoplasty (or breast augmentation) with silicone prosthesis will choose to take out the prosthesis when preparing for pregnancy, probably because they are worried about safety. Here I emphasize that medical silica gel has been used in clinic for decades and has been widely used, which is safe (non-toxic).
Reference of cost for augmentation rhinoplasty with silicone prosthesis
At present, silicone prostheses used for rhinoplasty mainly include Kangning, domestic Wanhe and imported Korean bionics. The cost of rhinoplasty with these prostheses is generally between 3000-8000 yuan, and the cost of a prosthesis in Korean bionics exceeds 1000 yuan. However, as mentioned above, it is generally not recommended to take a vacation in the nose at present, so plastic surgeons usually trim the "L" prosthesis into an "I" prosthesis, and the softer and more expensive materials in the nose are actually discarded.
If you choose silicone prosthesis for rhinoplasty, the surgical plan is to pad the bridge of the nose with only "I" prosthesis, then you can only pay attention to the material at the back of the prosthesis, which may save some money. Of course, you may ask, why don't prosthesis manufacturers directly produce "I" silicone prostheses? The answer is no.
2. Expanded polytetrafluoroethylene (e-PTFE)
Expanded PTFE (hereinafter referred to as "Expanded PTFE") is an inert expanded polymer, which is composed of many PTFE nodules with fine fibers interwoven in many directions and has an ultra-micro porous structure. These micropores allow tissue to grow, braking it and being accepted by the body's immune system.
Advantages and disadvantages of expansion
Advantages of swelling: the texture of the material is close to normal nasal tissue, and the histocompatibility is good, and the rhinoplasty effect is generally more natural than silicone; Its microporous structure allows tissue to grow in, which is not easy to slide and has good stability; The swelling material has good biocompatibility and less rejection reaction; Expansive materials have no light transmittance of silicone rubber; The expanded material has light weight, no obvious feeling of falling, and will not cause compression and atrophy to bone tissue.
Disadvantages of swelling: Because it is not soft enough to provide structural support, such as raising the tip of the nose and the columella, it is difficult to take out the silicone prosthesis once there is a problem. In addition, the carving and implantation technology of augmentation is more complicated than that of silicone prosthesis, which is also one of the reasons for the high incidence of clinical complications. In addition, ligand materials are much more expensive than prostheses.
The main disadvantage of rhinoplasty is that it is easy to be infected. Expanded microporous virus can enter, but human immune cells can't, so once infected, only one can be taken out. According to my personal experience, early infection after augmentation rhinoplasty can be effectively controlled if the operation process is strictly aseptic and the swollen materials are strictly prevented from being contaminated. Long-term postoperative infection is generally related to patients' bad habits, such as picking their noses. Therefore, it is very important for patients with rhinoplasty to strictly follow the doctor's advice and maintain the health and hygiene of the nose. According to literature reports and my experience, the infection rate of swelling is about 3%, which is a problem that you must weigh when choosing swelling.
Cost reference of augmentation rhinoplasty
At present, there are three brands of rhinoplasty: Li Xiu, Jin Jifeng and Xu Erting, which are made in China. The cost of augmentation rhinoplasty and breast augmentation is about 12000- 18000, and imported ones are more expensive than domestic ones. The peak cost of breast augmentation prosthesis is close to 30 thousand, but it should be used with caution. Because the swollen material is soft and not suitable for rhinoplasty, the swelling used for rhinoplasty is generally type I, and then the doctor will carve it into a shape suitable for your foundation when rhinoplasty.
3 Autologous cartilage
Autologous cartilage used for transplantation is usually taken from nasal septum cartilage, auricular cartilage and costal cartilage. Specific to the bridge of the nose, Europeans and Americans often use septal cartilage, while Asians generally do not have such a large bone mass. Costal cartilage is an ideal transplant material for patients who cannot accept prostheses because of its sufficient strength and sufficient tissue mass.
Advantages and disadvantages of augmentation rhinoplasty with autogenous costal cartilage
Advantages of autogenous costal cartilage augmentation rhinoplasty: good biological tolerance, strong anti-infection ability and easy survival; Good elasticity, easy carving, low incidence of adverse reactions such as swelling and absorption; It has no rejection, has certain biological strength and can be used as a supporting structure; It belongs to its own tissue, easy to survive after transplantation and can become a part of the body.
Disadvantages of augmentation rhinoplasty with autogenous costal cartilage: As an implant of augmentation rhinoplasty, costal cartilage is hard in texture and may be easily displaced and deformed. Another operation on costal cartilage will cause damage to the donor site, and the unstable factors of the effect make it questionable. In order to solve the problem of deformation and absorption of costal cartilage after transplantation, plastic surgeons have tried their best, such as carving costal cartilage specially, embedding it with steel wire and cartilage with bone. All these methods have certain improvement effects, but in general, costal cartilage rhinoplasty has not been widely used.
Reference on the cost of autologous costal cartilage cushion bridge of nose
Costal cartilage is its own, and there is no charge for materials, but there is a charge for taking costal cartilage and inserted costal cartilage. The fees charged by each hospital and doctor may be different. The cost is about 65438+100000 yuan. Of course, this only refers to the cost of the costal cartilage pad of the bridge of the nose.
4 Some misunderstandings about filling the bridge of the nose
A woman with a low nose bridge may see that her nose bridge is missing too much when looking in the mirror, so it is easy to go to the other extreme when deciding to have surgery and blindly pursue rhinoplasty. This overcompensation psychology may bring disastrous consequences: using a thickened prosthesis to pad the bridge of the nose may lead to redness and congestion of the skin, thinning of the skin, and even bursting and wear of the prosthesis.
No matter how many face-changing stunts you see in Chinese and foreign film and television dramas, believe me, those are just legends. Plastic surgery is both medicine and science. You and plastic surgeons should respect your organizational foundation, and your organizational foundation also limits what doctors can achieve. It is absurd and unrealistic to think that your nose can be as high as you want, and that plastic surgeons can make your nose as high as you want. Using a prosthesis that exceeds the tolerance of skin tissue, the result is long-term irreversible tissue deformity, which is difficult to correct!
In this information society, many people's aesthetics are westernized, and there is no problem in westernizing aesthetics, but your organizational foundation will not be westernized. From the perspective of plastic surgery, there are great differences in nose shape, structure, aesthetic requirements and surgical purposes between eastern and western people. The nose of westerners is characterized by full development, prominent structure, clear outline and strong three-dimensional sense. Histologically, cartilage structure is wide and thick, and subcutaneous tissue is thin. The main reasons for seeking surgery are overgrowth deformity, such as humpback correction, aquiline nose correction, crooked nose correction and so on. The operation mainly focuses on pruning and removing various structural components. China people's noses are soft, small and delicate. The reasons for the need for surgical plastic surgery are mostly hypoplasia, such as flat nasal root, wide alar and insufficient nose tip protrusion. Tissue characteristics are cartilage stenosis and weak support. Except for the larger alar, which needs to be excised, the other operations are mainly filling.
There are obvious differences in the shape and anatomy of the nose between orientals and westerners, which also determines the need for different operations. If you and your plastic surgeon neglect your tissue foundation, you must make a European nose. If you draw a tiger dog, there may be long-term irreversible tissue deformity that is difficult to correct.
5 Other problems of nasal dorsoplasty
Rhinoplasty, another thing to say is the design of nasal root point and the correction of hunchback nose.
In rhinoplasty, the position design of nasal root point is very important. At present, the aesthetic view holds that the nasal root point should be slightly higher than the pupil level and parallel to the wrinkle plane of double eyelids, while in the past, it was considered that the nasal root point was the midpoint of the pupil center line. The position of the nasal root point should not be too high, otherwise it will become Tian Tong's nose.
Although orientals usually show underdeveloped noses, there are also a few over-developed noses. The camel's hump nose is characterized by a wide back, a wide nose wing and a long tip. Camel's hump nose gives people a feeling of losing face, which is not easy to get close to, especially not conducive to showing women's femininity and roundness. Camel hump nose is mostly caused by congenital reasons and local tissue overgrowth during development, and occasionally caused by nasal bone trauma twisted healing or callus hyperplasia in the later stage. There is no dysfunction except morphological abnormality, and it will not affect the sense of smell, pronunciation and respiratory function.
Congenital or acquired humpback nose can be corrected, no matter whether its humpback is high or low, big or small, and whether it is accompanied by long nose tip and curved nasal septum. There are two ways to correct camel's hump nose: nose plastic surgery, including comprehensive plastic surgery of chiseling out the prominent bones and cartilage, shortening the nose length and repairing the tip of the nose; For trauma, combined with the specific characteristics of deformity, the above principles can be used for surgical correction.
(Excerpted from: Qiu, Taipei Fabo Fashion Clinic, Fabo Rhinoplasty, Taipei Fabo Medical Beauty)