Kim Cheol Hwan
Seoul, Republic of Korea From the Department of Plastic Surgery, Winners Clinic.
Plast Reconstr Surg. 2015 Apr;135(4):1033-1036. doi: 10.1097/PRS.0000000000001107.
To achieve the desired refinements in Asian patients, sufficient septal cartilage is needed for ideal tip projection and lengthening of the nose by the septal extension supported by the stable septum. There are many cases of insufficient septal cartilage in Asian patients. For optimal outcome, the author proposes a new technique, the so-called flag technique, which uses a tip-strut complex in a flag-like shape.
Using the open approach in 161 patients, an elongated columellar septal strut graft was sutured to the medial crura, and bilateral mini-spreader grafts in triangular or trapezoidal and flag-like shapes were attached bilaterally on both sides of the upper part of the strut graft, with a shield-shaped graft on the caudal edge of the upper part of the strut graft.
There were significant improvements in three parameters for evaluating tip projection preoperatively and postoperatively. When compared with the ideal figure, the results are very effective in the ratio of tip projection to the distance from the tip to the vertical line of the upper lip, but there were significant differences in the ratio of nasal length (radix to tip) to tip projection and the ratio of alar base width to the width between each side of the tip-defining points.
The flag technique of using a tip-strut complex in a flag-like shape is an alternative method of tip-plasty in Asian rhinoplasty with insufficient septal cartilage.
为了在亚洲患者中实现理想的鼻整形效果，需要足够的鼻中隔软骨，以通过稳定的鼻中隔支撑的鼻中隔延伸来实现理想的鼻尖突出度和鼻长度延长。亚洲患者中存在许多鼻中隔软骨不足的情况。为了获得最佳效果，作者提出了一种新技术，即所谓的旗状技术，该技术使用旗状的鼻尖支撑复合体。
对161例患者采用开放式手术方法，将延长的鼻中隔鼻小柱支撑移植物缝合至内侧脚，并在支撑移植物上部两侧双侧附着三角形、梯形或旗状的双侧微型撑开移植物，在支撑移植物上部尾缘放置盾牌状移植物。
术前和术后评估鼻尖突出度的三个参数有显著改善。与理想数据相比，鼻尖突出度与鼻尖至上唇垂直线距离的比值结果非常有效，但鼻长度（鼻根至鼻尖）与鼻尖突出度的比值以及鼻翼基底宽度与鼻尖界定点两侧之间宽度的比值存在显著差异。
使用旗状鼻尖支撑复合体的旗状技术是鼻中隔软骨不足的亚洲鼻整形术中鼻尖整形的一种替代方法。
