The characteristics of silica gel and expansive materials are analyzed. First of all, silica gel material is hard and elastic, easy to process and shape, with strong plasticity, wide sources, low cost and long application history. Most doctors are familiar with silicone material, which is easier to implant during surgery and not easy to deform after clamping, so it is still the mainstream choice of many doctors in China. However, silicone prosthesis also has some insurmountable shortcomings: first, silicone prosthesis is composed of silicone molecules, which is irritating to our tissues and cells. After a long time, it will cause some changes in the tissues we contact, such as thinning of skin and subcutaneous tissue or swelling and congestion of subcutaneous capillaries. Therefore, after augmentation rhinoplasty with silicone prosthesis, the skin on the back of the nose tends to be shiny and red, the tip of the nose becomes sharp and the skin becomes thinner. This is an unnatural phenomenon, which our doctors call "bird". For people with small nose and thin skin on the back of nose, the above phenomenon is easy to occur when silicone prosthesis is implanted. In view of the above shortcomings of silicone prosthesis, in addition, because silicone can not be closely combined with human tissue, some doctors are not skilled, the size of the stripped cavity is not appropriate, the level is not accurate, and the prosthesis is easy to shake and shift left and right after operation. At present, in Europe and America, silicone prosthesis has been withdrawn from the field of plastic surgery and replaced by expansive materials.

The so-called expansion, the full name should be expanded polytetrafluoroethylene (e-PTFE), which was first developed by Gore-Tex Company in the United States. Originally used in cardiovascular surgery, such as artificial blood vessels. 1989 was first used in nasal plastic surgery by American doctor Rothstein, which opened the application of e-PTFE in plastic surgery.

The expanded material has very fine pores into which human tissue cells can grow, so its histocompatibility is very good, it is very stable in the human body, it is not easy to reject, and it is firmly combined with autologous tissue, so the implanted prosthesis is not easy to move and displace. In addition, because the expanded material is soft and can be closely attached to the autologous tissue after implantation, the postoperative appearance and feel are more natural and realistic.

Of course, expansive materials also have some disadvantages. First of all, due to the complex manufacturing process and high material price, its popularization is restricted; In addition, because the swelling is soft and not strong enough, the effect is not ideal in the operation that needs to raise the nasal tip. It is not easy to process and shape during the operation, and some doctors quit because of this, which is also a reason why they are unwilling to choose bulking. In addition, swelling has an infection problem. A patient asked me if swelling is more susceptible to infection than silica gel. In fact, when I summed up my experience of applying detumescence, I found that the postoperative infection rate of detumescence was lower than that of silica gel. So why is swelling more susceptible to infection? I analyze the reasons as follows:

1. Because the swelling is not easy to handle, the time for doctors to carve the swelling during the operation will be prolonged, which invisibly prolongs the time for the swelling to be exposed to the air;

2. Because the air in the operating room cannot be absolutely sterile, the probability of swelling being contaminated by bacteria in the air will be higher than that of silicone prosthesis;

3. Because the swollen structure is composed of countless micropores, bacteria in the air may be hidden in these micropores. Once the swelling is contaminated by bacteria during the operation, the bacteria are easy to hide, and such swelling may be infected after being implanted into the human body;

4. Because the bulking body has the structural characteristics of micropores, it is not allowed to squeeze and clamp excessively when processing and preparing bulking body and implanting bulking body, otherwise the structure of bulking body will be changed and the bulking body will be deformed. Therefore, implants are more difficult to place than silicone prostheses, especially through nostril incision, which requires certain surgical skills. If the doctor is not skilled in the operation, it may not be implanted smoothly at one time, and it may need to be repeated many times, which will inevitably cause swelling to contact with nasal hair and nasal mucosa in the nostrils, and also increase the chance of swelling being contaminated by bacteria.

To sum up, I think if the above problems are not handled properly in the process of using detumescence, it will definitely lead to an increase in infection rate after detumescence. So, what I want to tell you here is, don't worry, I have taken adequate safeguard measures against the above factors that are easy to induce infection. First, because of the use of expansive materials for many years, I have accumulated some experience, which is fast and accurate in the process of selecting materials, processing and carving expansive materials, shortening the time for preparing expansive materials; Secondly, I also need special disinfection during the operation to ensure that it meets the aseptic requirements. Thirdly, carina implantation is the key step, and a set of effective methods summarized for many years are adopted to ensure the success of carina implantation at one time, so as to achieve gentle movement, clear hierarchy and accurate position. Due to the effective mastery of the above links and the rational use of antibiotics after operation, there is no increase in infection rate after expansion.

Another question often mentioned by patients is whether the swelling can be removed after implantation, because someone has seen this on the Internet. I think these statements must have been made by doctors at first. The reason is nothing but ignorance or inexperience; Either you are afraid to use bulking on the pretext that you are not skilled. Here, I can tell you responsibly, don't worry after implanting the expansion material, you can take it out quickly at any time as long as you like.

In addition, what needs to be explained to friends about puffiness is that puffiness and puffiness are still very different according to the different production technology, structure and use, which is manifested in the great difference in hardness, elasticity, plasticity and softness. It is precisely because everyone's nose has different basic conditions and requirements. For example, some people demand natural softness, while others demand straightness and clear lines. Before the operation, I will choose the appropriate type of swelling reduction according to the specific situation to meet individual needs.

To sum up, because swelling has better histocompatibility than silica gel, the postoperative performance is more natural and realistic. Therefore, the application of swelling is becoming more and more common at home and abroad, and it has the potential to replace silicone in the field of rhinoplasty.