After long-term clinical observation by plastic surgeons, silicone rubber is widely used in plastic surgery. Its price is relatively cheap, and the technical requirements for doctors are not high, so it is easier for general doctors to master the method of taking and putting. However, its material is hard and its feel is not realistic. And can transmit light in sunlight. Many patients report that in the bright spot, they will find their parts glowing and sweating.
At present, the most advanced rhinoplasty material is swelling material. This material has been widely used in plastic surgery abroad. Extremely stable in nature and will not react with other substances; Non-toxic, carcinogenic and teratogenic; Soft texture, easy carving and strong plasticity; After the operation, when the patient thinks that the appearance is not ideal, he can easily take it out completely without leaving any defects. Its greatest advantage is that it feels realistic and opaque, and blood vessels can be inserted into this material to make it stronger.
At the same time, there are many kinds of rhinoplasty materials currently used. Some injectable liquid materials fuse with surrounding soft tissues after injection, so it is very difficult to take them out completely. Their most fatal disadvantage is that once the effect is not ideal, it is not easy to take them out completely, which makes plastic surgeons have a headache.
What kind of material is best for you? You'd better consult a professional doctor first and listen to the advice of experts. Different substances have different storage time in human body.
Nose shaping
1. Is nose surgery both horrible and painful? Rhinoplasty under painless anesthesia
Recently, intravenous anesthesia has appeared in developed countries, and you can operate on the same day and leave the hospital on the same day. This kind of anesthesia is called painless anesthesia (sleep anesthesia), which almost eliminates the instant pain that can be felt during anesthesia.
The method of painless anesthesia is to inject propofol intravenously to guide the patient to sleep before anesthesia, and then perform local anesthesia, thus eliminating the pain during anesthesia and the fear of surgery. After the operation, the patient seems to have just woken up from a dream and can regain consciousness in time. This anesthesia method is generally used in large hospitals with complete monitoring equipment, and painless anesthesia is generally used in nasal surgery in our hospital.
2. The standard of ideal nose
The shape of the nose is obviously different according to individuals and races, and the shape has a great influence on the appearance. Generally, the noses of Europeans and Americans are high and narrow, the noses of orientals are low and wide, and the noses of Koreans are oval. The nose is located in the center of the face, which makes the face three-dimensional, so it plays an important role in the decision of the first impression in interpersonal relationships.
* Observe the standard of ideal nose.
Length: about 65438+ 0/3 of the face. Starting from the position between the eyebrows and eyelashes, the side shape: naturally inclined to the tip of the nose. Angle: It feels a little (about 100 degrees to about 105 degrees). Bridge of nose: Seen from the front, this is a very correct shape. The size of the alar is smaller than the width of the lips and the distance between the inside of the eyes.
3. Can you turn into a beautiful woman by raising your nose?
When it comes to rhinoplasty, we can only associate it with silicone rhinoplasty. However, any experienced plastic surgeon knows that simple rhinoplasty can't achieve 100% satisfactory results. It is difficult to guarantee satisfaction if you only do rhinoplasty without correcting the low nose. The angle of nose and upper lip is also very important, which may give people a feeling of depression and clumsiness from the side. It is necessary to grasp the above factors as a whole and use various surgical techniques to create a very beautiful and harmonious shape.
Nasal plastic material
1.Gore-tex (expanded polytetrafluoroethylene)
1) advantages of goltes
A. It is softer than silicone rubber and more natural after operation.
B. there is no redness at the tip of the nose after the operation.
C. the tissue can grow into the material and be fixed for a long time.
D. The tip of the nose is very soft after the operation. If the patient doesn't say it himself, no one can see that he has received rhinoplasty.
E. It is also easy to operate for patients with thin nasal skin.
Shortcomings of Goltes
A. Because of good curing, the material and human body become a whole, which is more difficult to remove than silicone rubber.
Of course, because one-time operation can be maintained permanently, this problem will only occur when you are not satisfied with the effect of the operation and need another operation. But surgeons with rich experience in this material generally have mastered the special skills of demolition, so don't worry.
B.it's more expensive than silicone rubber.
C. sculpture needs rich experience.
2. Silicone rubber
1) Advantages of silicone rubber
A. Plasticity is relatively easy, and it is also easy for doctors with less experience to use, and the operation time is short.
B. You can raise the bridge of the nose and the tip of the nose at the same time through one operation. However, this method is easy to make the tip of nose red, so it is best not to use silicone rubber alone in nasal tip plastic surgery.
C. This material can also be used for aquiline nose plastic surgery with prominent nose bridge.
2) Disadvantages of silicone rubber
A. After silicone rubber enters the human body, a thin fiber envelope will be formed around it. The contraction of the fibrous capsule will cause surgical marks on both sides of the nose.
B. If this material is also used in nose tip plastic surgery, the nose tip may turn red under tension. .
C. the tip of the nose is too hard to lift.
D. Very few people have allergic reactions to silicone rubber.
※ If you want to avoid the side effects of 2) and 3) above, please be careful not to use silicone rubber for nose tip shaping. The tip of nose and cartilage should be corrected separately. Silicone rubber has been used in nasal tip plastic surgery in our hospital, but the above side effects have not appeared so far.
3. Artificial leather
After removing the cells that trigger immune response in epidermis and dermis, the dermis with three-dimensional structure of dermis was initially maintained by rapid freezing and dry bath. Because it retains the original skin components of human body, it is convenient for transplantation and skin grafting. Mainly used for rhinoplasty of soft materials. Because of the side effects of silicone rubber, the skin at the tip of the nose becomes thinner, which is used to ensure the health of the skin at the tip of the nose when another operation is needed.
4. Self-organization
Autologous tissue refers to materials extracted and used from one's own body. Because it is its own organization, it has the most organizational affinity. But because it is to be taken out from other parts of your body, it will leave a surgical scar on the removed part.
1) Cartilage is the most commonly used material in its own tissue. Ear cartilage, nasal septum cartilage and costal cartilage have been used. Because costal cartilage can leave scars on the chest, ear cartilage and nasal septum cartilage are often used.
2) Ribs, pelvis and skull can also be used, but these self-made tissues are only used for large-scale surgery. Cosmetic surgery is generally not used. If the nose is deformed due to trauma, it may be used for nasal reconstruction.
3) Dermal fat can be extracted from buttocks or crotch, which is mainly used to pad the bridge of the nose during surgery.
4) Fascia should be extracted from lateral head tendon, and it can only be extracted after scalp cutting. Because it will leave scars on the scalp, it will not be used unless it is absolutely necessary.
Classification and flow of nasal plastic surgery
Nasal plastic surgery should fully consider the overall coordination and coordination with surrounding structures. If immature teenagers undergo nasal surgery, it will hinder their development and may also lead to deformation. Therefore, cosmetic rhinoplasty should be performed after 17~ 18 years old. Nasal surgery is a combination of independent operations for different parts of the nose. According to different personal characteristics, different surgical methods will be adopted.
1. rhinoplasty
1) The definition of rhinoplasty is to change the height and shape of the nose by implanting appropriate materials to make it coordinate with other parts of the face. In Korea, the operation of implanting materials suitable for the human body to make the bridge of the nose and nose protrude is called rhinoplasty. In Korea, rhinoplasty accounts for the majority of nasal surgery. Most orientals have low noses, giving the impression that their faces are wide and clumsy. Rhinoplasty will make the face look narrower and give people a different impression. Therefore, plastic surgeons do not unconditionally emphasize rhinoplasty, but focus on correcting the overall shape.
2) Materials for rhinoplasty There are two kinds of materials for rhinoplasty, one is autologous tissue and the other is artificial plastic material. The materials for nose bridge plastic surgery are mostly silicone rubber and Gore-tex, and the materials for nose head plastic surgery are mostly cartilage and expanded polytetrafluoroethylene. The commonly used material is cartilage or dermal fat extracted from autologous tissue, namely ear or nasal septum. Silicone rubber has always been the most widely used artificial plastic material, but the frequency of using expanded polytetrafluoroethylene has increased recently.
3) Surgical methods The incision of rhinoplasty is generally located at the edge of the columella near the nostril, and no incision marks can be seen on the outside. The material is inserted into the periosteum forming space along the nasal bone, and then a filler made according to the characteristics of the nose is implanted. There is no need to remove stitches after operation, because the suture is a hand suture that does not leave scars and disappears. If nasal tip plastic surgery is needed afterwards, the operation will continue. According to the specific situation, there are also cases where cartilage and tissue are corrected according to personal wishes after the nasal structure is completely exposed.
4) Precautions Although there are no cases that cannot be operated on, patients who have suffered from sinusitis for a long time or have difficulty breathing due to severe nasal congestion should make a careful decision after thorough and detailed diagnosis. The characteristic of rhinoplasty is that you need to stuff something into your nose. The filling amount can be simply understood as the difference between the original nose height and the expected nose height. The elasticity of nasal skin is limited, and excessive rhinoplasty will make the nasal skin too thin, so the safe range that nasal skin can bear must be fully considered when rhinoplasty is performed.
2. Nasal tip and nose plastic surgery
The flat nose tip and the nose tip give people the impression that they are not competent enough. This phenomenon is caused by excessive development or abnormal configuration of nasal cartilage. It is necessary to free some cartilage or redistribute tissue to narrow the tip of the nose. Cut off the nasal tip and some muscle tissue of the nasal tip through the nostril edge to reduce the volume of the nasal tip. If it is necessary to make the tip of the nose protrude, ear cartilage or soft Gore-tex (scientific name expanded polytetrafluoroethylene) material can be used. The nose is relatively wide, and the nose can be directly cut through the incision on the edge of the nose wing. Nasal tip and nasal tip plastic surgery should coordinate a variety of surgical skills to improve patient satisfaction. Surgical incision is usually made at the edge of nostril, and there is no external scar after operation. Nasal tip and nasal tip plastic surgery can be performed together with rhinoplasty or separately.
3. Hook nose plastic surgery
Viewed from the side, the nose with a raised back and a drooping tip is an aquiline nose. It can be corrected by cutting off the hump, cutting off or freeing the long cartilage. If the nose is low or unnatural after correction, silicone rubber or Gore-tex can be used for rhinoplasty. Nose drooping needs rhinoplasty correction. The correction of the cartilage at the tip of the nose should form a charm curve by adjusting the position of the tip of the nose slightly upwards.
4. crooked nose plastic surgery (nose bending plastic surgery)
A nose with a twisted back or tilted to one side is a crooked nose. Distorted nasal septum may also be accompanied by nasal congestion. Correction of crooked nose is carried out through the edge of nostril, so there will be no scar on the appearance of nose. The operation of deviated nose is an operation to peel off some cartilage along both sides of nasal cartilage and correct the position. If the nasal septum is also distorted, it should be corrected at the same time. If only the nasal bone is corrected and the nasal septum is not corrected, the nasal bone may be twisted again after a period of operation.
5. Short nose plastic surgery
Short nose plastic surgery is not easy. Because of the short nasal bone, the distribution of nasal cartilage is very difficult, and it is also difficult to solve skin problems. The only part that can be corrected by surgery is cartilage. Cartilage should be redistributed in the desired elongation direction. However, because the tightness of the skin always pulls the cartilage back to its original position, a tissue is needed to maintain the redistributed cartilage length. It is the key point of short nose surgery to increase the length of nose and keep it without damaging the tip of nose.
6. Long nose plastic surgery
Long nose surgery is an operation to shorten the nasal bone and improve the height of the nasal tip.
Long nose plasty is the operation that needs the most skill and experience in the correction of nasal tip cartilage.
7. Wide nose bone repair
Surgical removal of the nasal bone along the longitudinal sections on both sides of the nasal bone to reduce the nasal bone.
Surgery and pain
Surgery and pain.
Nasal surgery is usually performed under local anesthesia. Anesthesia is a little painful, and there will be no pain during the operation.
2. Surgery and hospitalization
You don't need to be hospitalized after the operation, and you can receive regular treatment.
3. Surgery and rehabilitation
There is almost no pain after the operation. If there is pain, taking painkillers can eliminate it. Ice has a great effect on postoperative edema. The edema was basically eliminated within one week after operation. After 5 days of operation, 80% of the edema will be eliminated, and then you can start a normal life. The operation of hook nose or crooked nose adjusts the bone structure of the nose and requires a recovery period of about 2 weeks. You need to go to the hospital for treatment 2~3 times a week after operation.
As early as 80 years ago, people used vaseline, alum, ceramics, gold, silver, platinum, celluloid, ivory, and even stones, nails, duck sternum and toothbrush handles in the Black Sea. As a filling material for saddle nose repair and rhinoplasty. The above materials may be too irritating and the discharge rate is high; Or fragile and easily broken; Or because the price is high and the source is difficult, they have all been abandoned. In the 1920s, liquid paraffin was widely used as a filler for decades, and it was not used until it was widely reported that it was easy to cause paraffin tumors. In recent 30 or 40 years, with the rapid development of chemical industry, various polymer materials have come out one after another and been applied to plastic surgery, and good results have been achieved. But for rhinoplasty, because of the high discharge rate and uncertain long-term effect, many doctors advocate using autologous bone tissue or cartilage tissue as rhinoplasty material. However, due to the absorption of bone tissue and the increase of patients' pain, its application is also limited. Clinical application shows that the materials used in rhinoplasty, whether autologous or allogenic, active or inactive, natural or chemically synthesized, have certain advantages and disadvantages, and should be selected according to the specific situation.
1, autologous bone 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 of rhinoplasty is mostly taken from ilium, but also from ribs, tibia, skull and so on. Autologous bone augmentation rhinoplasty has some problems, such as poor elasticity of bone tissue and difficult shaping. Therefore, the postoperative appearance is not very natural, the autogenous bone is inconvenient to obtain, the bone source is limited, and the resection will cause secondary pain and even complications for the patient. Bone resorption can also occur for a long time, leading to changes in external morphology, which is difficult for patients to accept. At present, it is rarely used in rhinoplasty and beauty. However, for the correction of complex nasal deformity or severe saddle nose, autologous bone transplantation is still needed.
2. Allogeneic tissue
Rhinoplasty with allogenic tissue refers to rhinoplasty with fresh cadaver bone and cartilage tissue as rhinoplasty materials after special treatment. After augmentation rhinoplasty, allogenic bone and cartilage only played a temporary mechanical support role, and were eventually replaced by autologous bone. Because of the difficulty in source, quantity and quality, allogenic tissue was gradually abandoned.
3. Heterogeneous organizations
At present, the heterogeneous tissues used for rhinoplasty mainly include bovine nasal septum cartilage, bovine costal cartilage and calf sternum, which can be used for human rhinoplasty after special treatment. Its advantages are convenient and abundant materials and easy molding. Its disadvantage is that although it has been specially treated, some individuals still have weak antigenicity and may be rejected: they have different degrees of absorption, so the long-term effect is not satisfactory. It is difficult to be widely used because it can only be used in human body after special treatment. At present, few people use heterogeneous tissues in rhinoplasty.
4, biological tissue substitutes
With the development of science and technology and the progress of chemical synthesis industry, biological tissue substitutes suitable for human body have become a reality. The progress of tissue substitutes will promote the development of cosmetic plastic surgery. In 1970s, the commonly used biological tissue substitutes were liquid silica gel, ivory, dental materials, solid silica gel, artificial bone materials and expanded polytetrafluoroethylene.
In the late 1970s and early 1980s, liquid silica gel was widely used in China. After rhinoplasty with liquid silica gel injection, clinical observation proves that it can cause persistent erythema, swelling, skin necrosis of bridge of nose, tooth swelling and even facial disfigurement. Moreover, liquid silica gel can diffuse, permeate and permeate around, and there is no clear boundary, so it is difficult to handle. The United States has strictly banned the use. Many domestic scholars advocate that it is forbidden to use it or use it with caution.
Ivory: ivory has good biocompatibility and generally does not cause rejection, but it is gradually abandoned for rhinoplasty because of its high hardness, difficult carving and animal protection.
Tooth-building materials: polymethyl methacrylate (PMMA) is a tooth-building material used in rhinoplasty, and it is one of the solid biological tissue substitutes used in rhinoplasty earlier. Good biocompatibility, it needs to be blended when it is used for rhinoplasty, and it is very easy to be polluted. If the pollution is not completely removed before operation, it will easily lead to complications such as infection, pain and rejection. Its prosthesis preparation is complex and the operation is relatively difficult, so it is rarely used at present.
Solid silica gel: it is a common rhinoplasty material at present, and it is a polymer silicide. 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 and low price. Its main disadvantage is that it can not establish blood circulation with the body and form tissue connection, and it is only wrapped by fibrous tissue, so it can penetrate the skin at weak tissue. Due to the contracture of fibrous capsule, it can cause the surface of silicone prosthesis to protrude, which affects the appearance effect.
Artificial bone material: mainly refers to 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. It has been widely used in stomatology and orthopedics. It has been used for rhinoplasty and cosmetology since the mid-1980s. It is easy to operate and shape, especially for people with low nose bridge, and the postoperative effect is particularly satisfactory. Because there is no supporting effect, it has poor effect on people with low nasal tip.
Expanded polytetrafluoroethylene (ePTFE): from the medical point of view, it is the most ideal biological tissue substitute at present. Because of its good biocompatibility and unique microporous structure, it is non-toxic, non-carcinogenic and non-allergenic. Human tissue cells and blood vessels can grow into its micropores to form tissue connections, just like autologous tissue. The effect of rhinoplasty with it is satisfactory. Expanded PTFE rhinoplasty material was introduced into China from the United States on 1995, but its high price affected its universal application.
Rhinoplasty usually takes 5-7 days to remove stitches, 15 days to recover, and it takes at least one month to fully recover.
This is the corresponding introduction, I hope it will help you!
References:
www.5 17mr.com