Chuangsuwanich Apirag, Lohsiriwat Visnu
Department of Surgery, Division of Plastic and Reconstructive Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand.
Indian J Plast Surg. 2013 Sep;46(3):533-7. doi: 10.4103/0970-0358.122004.
Asians have low nasal dorsum, thick skin envelope, low defined alar cartilage, low projection of nasal tip and broad alar base. Augmentation rhinoplasty with silicone prosthesis has been performed with predictable results, but unfavourable results and complications still present. This series show techniques and results from single surgeon experience.
We retrospectively reviewed 548 patients chart during January 1995 to December 2009. All patients underwent custom-made S-shape implant silicone augmentation rhinoplasty operated by a single surgeon. There were three major operative steps: (1) Intra-operative S-shape implant carving; (2) pocket dissection through bilateral rim incision and (3) tension adjustment before closure. All the patients were recorded for early surgical complications and satisfaction.
There were 519 women and 29 men. The mean age is 25.5 years (18-56 years). Mean follow-up period was 6 months (1-60 months). The majority of patient were appointed for esthetic augmentation (86.8%). 515 cases (94.9%) showed well satisfaction following the operation. The total complication rate was 6.5% (4.9% deviation, 0.7% extrusion, 0.5% hematoma and 0.3% infection). All the complications were corrected with uneventful sequelae.
Augmentation rhinoplasty with custom-made S-shape silicone implant by closed approach provides high satisfaction with acceptable early complication rate.
亚洲人的鼻背低、皮肤包膜厚、鼻翼软骨轮廓不明显、鼻尖突出度低且鼻翼基底宽。硅胶假体隆鼻术已取得可预测的效果，但仍存在不良结果和并发症。本系列展示了单一外科医生的技术和结果。
我们回顾性分析了1995年1月至2009年12月期间548例患者的病历。所有患者均接受了由单一外科医生进行的定制S形植入物硅胶隆鼻术。有三个主要手术步骤：（1）术中雕刻S形植入物；（2）通过双侧边缘切口进行腔隙剥离；（3）闭合前调整张力。记录所有患者的早期手术并发症和满意度。
有519名女性和29名男性。平均年龄为25.5岁（18 - 56岁）。平均随访期为6个月（1 - 60个月）。大多数患者进行美容隆鼻（86.8%）。515例（94.9%）患者术后表示非常满意。总并发症发生率为6.5%（移位4.9%、挤出0.7%、血肿0.5%、感染0.3%）。所有并发症均得到纠正，且无明显后遗症。
采用闭合入路的定制S形硅胶植入物隆鼻术满意度高，早期并发症发生率可接受。
