Byun Jin Suk, Kim Kenneth K
BS Aesthetic Clinic, Daegu, Korea; Dream Medical Group, Los Angeles, Calif.; and Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at University of California, Los Angeles, Calif.
Plast Reconstr Surg Glob Open. 2013 Oct 7;1(6):e45. doi: 10.1097/GOX.0b013e3182a85b29. eCollection 2013 Sep.
Asians with short nose lack the cartilage needed to extend the length of the nose. A rhinoplasty technique using lower lateral cartilage (LLC) repositioning and ear cartilage grafting allows for sufficient nasal lengthening and nasal tip mobility in the correction of short nose in Asians.
Short nose was classified into 3 subtypes: type I, II, or III. During LLC repositioning, the LLC was separated from surrounding retaining structures, except at the footplate. The LLC was approximated medially and advanced with a Medpor strut. A silicone dorsal implant was inserted to suit the newly projected nasal tip. An ear cartilage onlay graft or ear cartilage extension graft was applied to further project and enhance the nasal tip and columella.
Of the 854 primary rhinoplasty procedures performed on Asian patients between January 2008 and December 2011, 295 were performed on patients with short nose. LLC repositioning and ear cartilage onlay grafting were performed on 228 patients. LLC repositioning and ear cartilage extension grafting with or without ear cartilage onlay grafting were performed on 67 patients. Short nasal tip, alar retraction, and columellar retraction were corrected. Wound dehiscence with marginal necrosis occurred in 7 patients. One patient developed nasal infection.
LLC repositioning and ear cartilage grafting aid in the correction of short nose in Asians. With LLC repositioning and ear cartilage grafting, the nasal tip can be positioned in accordance with the patient's anatomic limits. The entire nasal tip and columella can be lengthened, while the tip maintains its mobility.
亚洲人鼻短,缺乏延长鼻长度所需的软骨。一种使用下外侧软骨(LLC)重新定位和耳软骨移植的鼻整形技术,在矫正亚洲人短鼻时可实现足够的鼻延长和鼻尖活动度。
短鼻分为3种亚型:I型、II型或III型。在LLC重新定位过程中,将LLC与周围的固定结构分离,但在脚板处除外。将LLC向内侧靠拢,并用Medpor支柱推进。插入硅胶鼻背植入物以适应新突出的鼻尖。应用耳软骨覆盖移植或耳软骨延长移植以进一步突出和增强鼻尖及鼻小柱。
在2008年1月至2011年12月期间对亚洲患者进行的854例初次鼻整形手术中,295例是针对鼻短患者进行的。对228例患者进行了LLC重新定位和耳软骨覆盖移植。对67例患者进行了LLC重新定位和耳软骨延长移植,有或没有耳软骨覆盖移植。短鼻尖、鼻翼退缩和鼻小柱退缩得到矫正。7例患者出现伤口裂开伴边缘坏死。1例患者发生鼻部感染。
LLC重新定位和耳软骨移植有助于矫正亚洲人的短鼻。通过LLC重新定位和耳软骨移植,鼻尖可根据患者的解剖学限度进行定位。整个鼻尖和鼻小柱可延长,同时鼻尖保持其活动度。