2. Technical principle

Plastic rhinoplasty is an operation to correct nasal deviation according to different reasons, which generally includes two methods in clinic. One is to correct cartilage distortion and remove excess cartilage; The other is the distortion of cartilage combined with bone, which needs to be corrected with bone instruments Surgery is a second-level project stipulated by the Ministry of Health, which has certain technical difficulties and needs to be treated in a regular hospital.

3. Adapt to the crowd and taboo crowd

1) adaptive population: congenital and acquired deviated nose, including simple nasal cartilage deformation and complex bone deformation.

2) Taboo crowd

① Cardiovascular and cerebrovascular diseases, liver diseases, diabetes, abnormal coagulation function and impaired function.

② Long-term use of anticoagulants, vasodilators and corticosteroids.

③ The focus of infected patients is in the nose and its surrounding skin.

(4) People who have psychological barriers, high expectations and are too strict with the contour of the nose.

⑤ Menstrual and lactating women.

4. Technical methods

1) The patient lies on his back, and the operating area and surrounding tissues are disinfected.

2) Anesthesia: Generally, local anesthesia is used.

3) Incision: A V-shaped incision can be made from the external nasal approach and the bottom of the nasal columella, or an arc incision can be made upward along the cartilage edge of the anterior nostril to connect with the nasal columella incision.

4) Stripping: separate the skin and subcutaneous tissue near the cartilage, separate the nasal periosteum near the superficial surface of the nasal bone and reach the root of the nose, or cut the periosteum with a scalpel and then separate it.

5) Plastic surgery of nasal cartilage and nasal bone

① Nasal cartilage plasty: cut the cartilage into a "mouth" or "field" shape at the arc bend, without separating the opposite mucoperiosteum, separate the mucoperiosteum of one nasal septum, keep the nasal septum cartilage, and push it from the convex side to straighten the nasal septum.

② Nasal cartilage combined with nasal bone plastic surgery: according to the degree of deformity, loosen the bone continuity around the nasal septum and the bridge of the nose, and then cut off and correct the distortion of different bone tissues. If necessary, the nasal saw can be used to correct the bone fracture to be corrected, so as to achieve the purpose of correction.

(Note: Other nasal deformities, such as hunchback, can also be corrected during surgery. )

6) Wound suture, external nasal fixation and pressure dressing.

5. Risks and complications

① Hematoma: Hematoma easily occurs around the nose and occasionally in the inner canthus. It is often caused by insufficient external pressure or injury to the dorsal nasal artery or medial canthus artery during osteotomy. Small hematoma can be absorbed naturally, and larger hematoma can be treated by internal medicine.

② Bleeding: postoperative bleeding is mostly caused by rough operation during operation or disorder of coagulation mechanism of patients.

③ Infection: Incomplete disinfection before or during operation may lead to postoperative wound infection.

(4) Secondary deformity: common deformity, first of all, the deformity at the base of the bridge of the nose; Secondly, the nasal dorsum on both sides is asymmetric, that is, the truncated nasal bone moves closer to the middle at different positions; The third is that the nasal septum cartilage is removed too much, which leads to nasal deformation.

⑤ The effect is not ideal: Improper selection of new posture or unstable fixation during operation may correct the poor appearance after operation.

6. Recovery time

The external nasal fixation can be removed about 3 days after operation, and the suture can be removed after 5-7 days of antibiotic treatment according to the doctor's advice. The complete recovery after operation varies with individual constitution.

7. Preventive measures

1)

① It is difficult to correct crooked nose, so it needs to be treated in a regular hospital or institution.

② Before operation, make sure that you are healthy, and there is no infectious disease or other body inflammation.

③ Don't make up before the operation.

Smokers need to quit smoking one week in advance.

2) Matters needing attention after operation

① Do not eat irritating food in the near future after operation.

(2) Minimize postoperative activities to prevent collision with the surgical site.

(3) It is forbidden to touch the surgical incision by hand after operation to avoid the incision from being affected with damp.

(4) follow the doctor's advice.