Tanaka Yohei, Matsuo Kiyoshi, Yuzuriha Shunsuke
Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Eplasty. 2011 Feb 16;11:e7.
The aging nose presents as a drooping nasal tip secondary to atrophy of the underlying bony support with a relatively prominent dorsal hump. We hypothesized that low nasal tip projection in the Asian nose may be secondary to the retropositioned anterior nasal spine (ANS) as well. Therefore, we investigated how filler injection between the medial crura and the retropositioned ANS affects the nasal shape.
Local anesthetic was injected on the ANS for analgesia and simulation for the following augmentation. To augment the retropositioned ANS, approximately 0.3 to 0.5 mL of injectable hyaluronic acid was injected between the footplates of the medial crura and the ANS. We evaluated 30 patients (29 women and 1 man) ranging from 21 to 71 years of age (36.5 ± 7.2 years) before and after the augmentation.
Augmentation of the retropositioned ANS significantly decreased nasal width, but increased alar length, nasal tip protrusion, inclination of the nostril axis from the horizontal, and columellolabial angle (P < .0001).
Our findings indicate that augmentation of the ANS elongates the pseudocolumella, lifts the medial crura, and affects the whole nasal shape. Consequently, augmentation of the retropositioned ANS with an injectable filler westernized the Asian nose. This temporary method may be useful to predict the results of ANS augmentation with other permanent fillers and to make a space to be filled with them.
衰老的鼻子表现为鼻小柱下垂，这是由于其下方骨质支撑结构萎缩以及鼻背驼峰相对突出所致。我们推测亚洲人鼻子鼻小柱低突也可能是鼻前棘（ANS）位置后移的结果。因此，我们研究了在内侧脚与后移的ANS之间注射填充剂如何影响鼻形。
在ANS处注射局部麻醉药以镇痛并为后续的隆鼻术做模拟。为了抬高后移的ANS，在内侧脚的足板与ANS之间注射约0.3至0.5 mL可注射透明质酸。我们评估了30例年龄在21至71岁（36.5±7.2岁）之间的患者（29名女性和1名男性）隆鼻前后的情况。
抬高后移的ANS可显著减小鼻宽，但增加鼻翼长度、鼻小柱突出度、鼻孔轴与水平线的倾斜度以及鼻小柱唇角（P <.0001）。
我们的研究结果表明，抬高ANS可延长假性鼻小柱、提升内侧脚并影响整个鼻形。因此，用可注射填充剂抬高后移的ANS可使亚洲人的鼻子具有西方人的鼻形特征。这种临时方法可能有助于预测用其他永久性填充剂进行ANS抬高的效果，并为填充永久性填充剂留出空间。
