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Plastic surgery of crooked nose-Yixing
Nine manifestations of rhinoplasty failure: 1. Infection: mostly related to incomplete disinfection before operation and irregular operation during operation. At present, it is rare for an operation to fail due to infection. 2. Change of skin color: It is a common problem after operation, which is characterized by redness and brightness of the skin on the back and tip of nose. It is mainly caused by the long-term stimulation of the prosthesis to the skin on the back of the nose. The degree of skin irritation is related to the following factors: 1, which is related to the material of the prosthesis. The harder the prosthesis is, the greater the irritation is. So in order to reduce the irritation to the skin, we first choose autologous tissue, followed by soft swelling. Silica gel is hard and irritating to the skin, especially the domestic silica gel we used in the early days, which is very irritating to the skin because of its many impurities. The high-quality medical silica gel used in recent years has much less irritation to tissues. When using silicone augmentation rhinoplasty, we should also be careful not to raise the tip of the nose excessively, which may easily cause the skin of the tip of the nose to be excessively tense and affect the local blood circulation, resulting in white or red skin of the tip of the nose, and in severe cases, it may also lead to silicone prolapse. Therefore, we all advocate the use of autologous cartilage at the tip of the nose to reduce complications. 2. It is related to the implantation level. The shallower the implantation level, the stronger the stimulation to the skin. 3. It is related to the thickness and sculptural shape of the prosthesis. The thicker the prosthesis, the more obvious the irritation to the back of the nose, especially those with thin skin. Choose a soft prosthesis that is not too thick. Also, when carving the prosthesis, the back of the nose is carved too steep, which leads to excessive local pressure, which affects local blood circulation and causes local redness and swelling. Third, the prosthesis is skewed: silica gel material has the advantages of being relatively stable and easy to carve and implant, but it is easy to skew due to technical reasons. There are several reasons why the implant is skewed: First, the cavity of the implant is not symmetrical enough when it is peeled off, and the cavity is naturally prone to skew when it is placed in the prosthesis. Second, the cavity is too wide to fix the implant and it is easy to move in any direction. Four. Prosthesis displacement: mainly occurs when silicone prosthesis is used, because the ventral surface of prosthesis is not closely combined with the back of nasal bone when the prosthesis is implanted under the fascia of nasal dorsum. In addition, the texture of silica gel is hard and the combination with surrounding tissues is not good enough. After a long time, it will slide. Many patients did not tilt when they finished rhinoplasty. Maybe two years later, they found that their noses were crooked or slippery. Many doctors are puzzled by this problem, so it is very important for doctors to carve not only the surface of the prosthesis, but also the ventral surface. Fifth, the effect distortion: mainly when carving the prosthesis, the angle of the edge of the carving prosthesis is too steep or the boundary is too obvious. After a period of time, you can see the boundary, so that the nose can clearly see the artificial traces. Especially for those clients with thin skin, they should be careful when choosing prostheses, try to choose soft and thin materials, and make a natural transition when dealing with the edges of prostheses. Sixth, the prosthesis is loose: the implantation level is too shallow, and the correct level should be under the periosteum. 7. Rejection: The rejection of bulking body is low, and the real rejection probability is only a few thousandths. Eight, the incision scar is obvious: mainly due to the choice of doctor's incision shape and incision suture skills. Many doctors choose the position of the incision on the edge of the nostril when rhinoplasty. If the incision position is not handled properly, it is easy to cause obvious scars and even nostril deformation. In order to avoid this situation, when I do rhinoplasty, I always put the incision on the inside of the nasal vault (inside the nostril, 3 mm away from the edge of the nostril), which increases the difficulty of the operation, but no scars can be seen outside. When choosing a columella incision, in order to reduce the scar, a tortuous incision is adopted, and the skin of the incision should be reconciled when sewing. Using a more complicated and tortuous incision when making a columella incision increases the difficulty of the operation, but accelerates the healing speed, improves the surgical effect, and makes the postoperative scar imperceptible to the naked eye. When sewing, try to use the imported thread, which is less irritating to the skin and shortens the time of thread removal as much as possible. 9. The postoperative effect is not satisfactory: in the process of dealing with customers, it is found that most customers are not satisfied with the surgical effect and make repairs. There are three main reasons for dissatisfaction: first, the customer's expectations are too high, and her basic conditions can't reach the effect she wants. Second, the doctor did not communicate with the customer enough, and did not fully understand the customer's requirements, so the nose made was not what the customer expected. Third, doctors' technical level and aesthetic standards are not enough. Many times, customers don't know exactly what kind of nose they want, so they leave it to the doctor. If the doctor's technical level is not up to standard, the effect will naturally be unsatisfactory. Some doctors have no technical problems, but they don't have good aesthetic standards, which don't conform to the aesthetic curve of modern people. The nose they make will never be a boutique. Doctors are now required to keep pace with the times in aesthetics and be brave in innovation in technology. A good doctor should be able to design a personalized nose that is most suitable for a customer according to the proportion of her five senses, instead of repeating the same thing. Good surgery is created, and a good doctor should learn to "never change from his Sect" instead of "never change from his Sect".