Park Seong Geun, Jeong Hoijoon, Ye Choon Ho
Joseph's Plastic Surgery Center, Daegu, Korea.
Arch Plast Surg. 2014 Nov;41(6):630-7. doi: 10.5999/aps.2014.41.6.630. Epub 2014 Nov 3.
A long nose with a drooping tip is a major aesthetic problem. It creates a negative and aged appearance and looks worse when smiling. In order to rectify this problem, the underlying anatomical causes should be understood and corrected simultaneously to optimize surgical outcomes. The causes of a drooping tip of a long nose are generally classified into two mechanisms. Static causes usually result from malposition and incorrect innate shape of the nasal structure: the nasal septum, upper and lower lateral cartilages, and the ligaments in between. The dynamic causes result from the facial expression muscles, the depressor septi nasi muscle, and the levator labii superioris alaeque nasi muscle. The depressor septi nasi depresses the nasal tip and the levator labii superioris alaeque nasi pulls the alar base upwards. Many surgical methods have been introduced, but partial approaches to correct such deformities generally do not satisfy East Asians, making the problem more challenging to surgeons. Typically, East Asians have thick nasal tip soft tissue and skin, and a depressed columella and alar bases. The authors suggest that multifactorial approaches to static and dynamic factors along with ancillary causes should be considered for correcting the drooping tip of the long noses of East Asians.
鼻尖下垂的长鼻是一个主要的美学问题。它会产生负面和显老的外观，并且在微笑时看起来更糟。为了纠正这个问题，应该了解并同时纠正潜在的解剖学原因，以优化手术效果。长鼻鼻尖下垂的原因通常分为两种机制。静态原因通常是由于鼻腔结构（鼻中隔、上外侧软骨和下外侧软骨以及其间的韧带）位置不当和先天形状不正确所致。动态原因则源于面部表情肌、降鼻中隔肌和提上唇鼻翼肌。降鼻中隔肌会压低鼻尖，提上唇鼻翼肌会向上牵拉鼻翼基部。已经介绍了许多手术方法，但纠正此类畸形的局部方法通常不能令东亚人满意，这使得外科医生面临的问题更具挑战性。通常，东亚人的鼻尖软组织和皮肤较厚，鼻小柱和鼻翼基部凹陷。作者建议，对于纠正东亚人长鼻的鼻尖下垂问题，应考虑针对静态和动态因素以及辅助原因的多因素方法。
