Jiangsu Provincial Hospital of TCM, Nanjing, Jiangsu Province, China.
Aesthetic Plast Surg. 2012 Oct;36(5):1028-38. doi: 10.1007/s00266-012-9945-7. Epub 2012 Aug 14.
An aesthetically short nose is very common in Asians. In the past few decades, rhinoplasty in China has focused mainly on the augmentation of the dorsum with alloplastic materials. Alloplastic materials used to augment the nasal tip or for nose lengthening rhinoplasty present a high risk of complications. Therefore, a recent trend in controlling tip projection and rotation is to use an autogenous cartilage graft in Asians. A strong septal extension is mandatory to increase the tip projection and lengthen the nose due to inadequate and inflexible nasal skin in short-nosed patients, whereas cap-and-shield grafting or defattening of the dome or suture modification are used only as additional methods, if necessary.
Between January 2008 and February 2012, a total of 113 Chinese patients (female-to-male ratio = 101:12) with different degrees of shortened noses, saddle noses, and/or round nasal tip deformities underwent open rhinoplasty. Silicone implants were used for nasal dorsum augmentation in 29 patients and e-PTFE was used in 84 patients. To evaluate the outcomes, nasal length, nasal tip projection, and nasolabial angle were measured pre- and postoperatively in 53 cases. The harvestable septal cartilage were carved into "a" and "b" strips, which were sutured in a "V" shape structure to extend the septum.
Of 113 cases, 78 patients were followed up for an average of 15 months (range = 1 month to 3 years). No major complications associated with implants or e-PTFE during the follow-up period were reported, with the exception of six cases with silicone dorsum augmentation that had an operative look. The results showed that statistically significant differences existed between the pre- and postoperative values in nose length and nose tip projection (p < 0.05). The nasolabial angle presented a reduced trend, although no statistically significant difference was found.
With limited harvestable septal cartilage, the modified technique of septal extension with a septal cartilage graft (or combined with auricular cartilage) is feasible and can effectively improve tip contour in short-nose rhinoplasty.
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在亚洲人中，短鼻是非常常见的。在过去的几十年中，中国的隆鼻术主要集中在使用异体材料来增加鼻背。用于抬高鼻尖或进行鼻延长的异体材料存在很高的并发症风险。因此，最近亚洲人控制鼻尖突出度和旋转的趋势是使用自体软骨移植物。由于短鼻患者的鼻皮肤不足且缺乏弹性，因此需要强有力的鼻中隔延伸来增加鼻尖突出度并延长鼻子，而鼻中隔软骨延伸（或结合耳软骨）则是必要的，而帽状移植物和盾状移植物或穹窿减薄或缝线修改仅作为必要时的附加方法。
2008 年 1 月至 2012 年 2 月，共有 113 例不同程度短鼻、鞍鼻和/或圆鼻尖畸形的中国患者（女：男=101：12）接受了开放式隆鼻术。29 例患者采用硅胶假体进行鼻背增高，84 例患者采用 e-PTFE。为了评估结果，在 53 例患者中测量了术前和术后的鼻长度、鼻尖突出度和鼻唇角。可采集的鼻中隔软骨被雕刻成“a”和“b”条带，以“V”形结构缝合以延长鼻中隔。
113 例患者中，78 例患者平均随访 15 个月（1 个月至 3 年）。随访期间，除 6 例硅胶鼻背增高患者外观不佳外，未报告与植入物或 e-PTFE 相关的重大并发症。结果显示，鼻长度和鼻尖突出度的术前和术后值之间存在统计学显著差异（p<0.05）。鼻唇角呈减小趋势，但无统计学差异。
在可采集的鼻中隔软骨有限的情况下，鼻中隔软骨移植（或结合耳软骨）的鼻中隔延伸改良技术是可行的，可以有效地改善短鼻隆鼻术的鼻尖轮廓。
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