Zelken Jonathan A, Hong Joon Pio, Broyles Justin M, Hsiao Yen-Chang
Dr Zelken is a plastic surgeon in private practice in Newport Beach, CA, USA. Dr Hong is a Clinical Professor, Department of Plastic and Reconstructive Surgery, Ulsan University College of Medicine, Asan Medical Center, Seoul, Korea. Dr Broyles is a Resident, Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA. Dr Hsiao is an Assistant Professor, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan.
Aesthet Surg J. 2016 Mar;36(3):287-96. doi: 10.1093/asj/sjv218.
Asian facial aesthetic surgery should enhance, but not change, natural features. Augmentation rhinoplasty is a hallmark of Asian cosmetic surgery. In the authors' experience, I-shaped implants can elevate and efface the radix, leading to an unnatural appearance (elevated radix deformity).
The Chimeric technique was developed to control final radix position and preserve the nasal profile. We aim to demonstrate that the Chimeric technique promotes forward projection, not elevation, of the radix.
Between 2013 and 2015, 49 patients underwent rhinoplasty with I-shaped implants. Nineteen patients had Chimeric dorsal-glabellar implants, 30 did not. Standardized photographs were obtained at every visit. Novel and established photogrammetric parameters were used to describe radix position and position change. A retrospective chart review provided additional procedural details and outcomes data.
Patients were followed for 10.8 months (range, 2-36 months). Nasal height increase (113% vs 107%) and bridge length increase (118% vs 105%) were significantly greater when the Chimeric technique was not performed (P < .0001). The nasofrontal angle increased 6° in both groups; there was no difference between groups. The vector of radix position change was 26.1° in the Chimeric group and 63.4° in the traditional group (P < .0001).
The Chimeric technique preserves the nasal profile with a favorable (horizontal) radix transposition vector. There was not a significant difference in final radix position when Chimeric rhinoplasty was performed because that is controlled by implant thickness and position. The technique did not blunt the radix significantly. LEVEL OF EVIDENCE 4: Therapeutic.
亚洲面部美容手术应增强而非改变自然容貌。隆鼻术是亚洲整形手术的一个标志。根据作者的经验，I形植入物可抬高并消除鼻根，导致外观不自然（鼻根抬高畸形）。
开发嵌合技术以控制最终鼻根位置并保留鼻外形。我们旨在证明嵌合技术促进鼻根向前突出而非抬高。
2013年至2015年期间，49例患者接受了I形植入物隆鼻术。19例患者使用了嵌合式鼻背-眉间植入物，30例未使用。每次就诊时均获取标准化照片。使用新的和既定的摄影测量参数来描述鼻根位置和位置变化。回顾性病历审查提供了更多手术细节和结果数据。
患者随访10.8个月（范围2 - 36个月）。未采用嵌合技术时，鼻高增加（113%对107%）和鼻梁长度增加（118%对105%）显著更大（P <.0001）。两组鼻额角均增加6°；组间无差异。嵌合组鼻根位置变化向量为26.1°，传统组为63.4°（P <.0001）。
嵌合技术通过有利的（水平）鼻根移位向量保留鼻外形。进行嵌合隆鼻术时最终鼻根位置无显著差异，因为这由植入物厚度和位置控制。该技术未显著使鼻根变钝。证据水平4：治疗性。
