There are two main methods of rhinoplasty, transplantation and implantation.
Transplantation: tissue transplantation, which mainly fills the nose with bone and cartilage tissue. Autologous bone tissue rhinoplasty is one of the earliest materials used for rhinoplasty. Its main advantages are easy survival after transplantation and no rejection. Autologous bone tissue used for rhinoplasty is mostly taken from ilium, skull, ribs and fibula. Autologous bone has some problems, such as poor elasticity of bone tissue and difficult to shape. So the postoperative appearance is not very natural. Moreover, it is inconvenient to obtain autologous bone and the bone source is limited. Cutting will also cause secondary pain and even complications. In the long run, bone absorption will occur, which will lead to changes in appearance, which is difficult for patients to accept. It has been used less. However, for the correction of complex nasal deformity or severe saddle nose, autologous bone transplantation may still be needed.
Autologous cartilage tissue
Autologous cartilage tissue is the most commonly used tissue in rhinoplasty. Its main characteristics are: no blood vessels, survival by tissue fluid, no stimulation to tissue after implantation, long-term maintenance of the original volume and cell morphology, easy to carve into the required size and shape, so the postoperative appearance is natural and realistic. Like autologous bone tissue, autologous cartilage tissue transplantation may also be absorbed and deformed.
Autologous fascia tissue
Fascia is hardly absorbed, but it will be compressed and thinned, and its volume will be reduced (about 20%). If used alone, it may require multiple operations. It is mostly used to wrap cartilage or artificial materials, which can reduce cartilage absorption and make the appearance natural and smooth. The earliest site was fascia lata, mostly superficial temporal fascia, and the surgical trace was small.
Autologous dermis/dermal fat
After transplantation, it is absorbed too much and rarely used. It is mainly used for patients with secondary rhinoplasty. It can also be used like fascia tissue. The cutting part is hidden, mostly under the coccyx and in the hip fold. Artificial materials are sometimes priceless to rhinoplastic surgeons, which can partially replace tissue transplantation, and even better than autologous materials in physical and chemical properties and lasting effects.
1: Expanded Polytetrafluoroethylene (EPPTFE)-made in America, which is the best rhinoplasty material in the world at present; The nose shape after operation is natural and realistic; However, the materials are expensive and the requirements for surgeons are high.
2. Solid silica gel nose prosthesis-rhinoplasty material commonly used by cosmetic plastic surgeons: it was used as early as 1972. After more than 20 years of observation, although the incidence of complications can reach 5%-20%, it is still one of the first choice materials for rhinoplasty because of its good biocompatibility, chemical inertia, non-toxicity, non-carcinogenicity and low price. Solid silicone nose prosthesis is a kind of solid polymer vulcanized at high temperature, which has certain elasticity and hardness. There are L-shaped and willow-shaped solid silicone prostheses, which are simple to operate and relatively cheap. The silicone materials used for rhinoplasty in plastic surgery hospitals are personalized prostheses carved by doctors according to the patient's nose shape, and the postoperative appearance is natural and realistic.
3. hyaluronic acid-hyaluronic acid, also known as hyaluronic acid, is an indispensable component in the skin tissue structure of organisms. As a part of body tissue, it has good histocompatibility. Hyaluronic acid injection rhinoplasty has the limitation of being absorbed by human body, but it has the advantages of no operation, quick response, high safety and moisturizing function, which can increase elasticity and lubricity and keep skin soft. The nose shaped by hyaluronic acid is natural and straight, and there will be no stiff feeling.
4. Artificial bone materials-mainly hydroxyapatite. It is the main inorganic component of human bone tissue, so it has good biocompatibility and no side effects such as teratogenesis, sensitization and carcinogenesis.