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Aesthetic Plast Surg. 2021 Feb;45(1):229-241. doi: 10.1007/s00266-020-01934-5. Epub 2020 Sep 9.
Of the first nasal tip modeling procedures performed, the Anderson tripod concept is the most well known, and many anatomy-related studies have analyzed the components involved in tip surgery. The main goals of nasal tip surgery are to stabilize the tip complex, which largely affects the shape, projection and rotation of the nasal tip.
The present study describes a new, original method, the double columellar strut and its main advantages compared to conventional techniques used for structural rhinoplasty.
The study involved 642 patients (496 women and 146 men, with an average age of 38.67 years) who underwent surgery between 2004 and 2018 by two operators. The patients were re-examined to evaluate the outcomes at least 1 year after surgery, and long-term results (15 years) were recorded for the oldest patients in regard to esthetics (projection, shape, rotation) and breathing function.
Of the 642 patients, 34 required a surgical revision for minor defects of the tip due to asymmetry, and the natural appearance after the first surgery was not affected. For the primary rhinoplasties, there were no breathing disorders that required revision surgery due to systematic restoration or preservation of the middle third.
The double columellar strut could be performed in the same conditions that the others conventional structural grafts. As a polyvalent alternative, it can be used with closed or open approaches and involves the use of only a limited amount of cartilaginous material. This anatomical approach yields natural results, acting as a foundation for controlling the shape, projection and rotation of the nasal tip. In addition, with or without complementary techniques such as the "tongue-in-groove" technique or tip grafts, the double columellar strut can be considered a "multifunction pocket knife" for tip surgery.
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在首次进行鼻尖整形手术中，安德森三脚架概念最为知名，许多与解剖相关的研究分析了鼻尖手术涉及的组成部分。鼻尖手术的主要目标是稳定鼻尖复合体，这在很大程度上影响鼻尖的形状、突出度和旋转度。
本研究介绍了一种新的、原创的方法，即双鼻中隔支撑及其与用于结构性隆鼻术的传统技术相比的主要优势。
该研究纳入了 2004 年至 2018 年间由两位手术医生进行手术的 642 例患者（496 名女性和 146 名男性，平均年龄 38.67 岁）。对这些患者进行了再次检查，以评估术后至少 1 年的手术结果，并记录了年龄最大的患者（15 年）的美学（突出度、形状、旋转）和呼吸功能的长期结果。
在 642 例患者中，有 34 例因鼻尖不对称等小缺陷需要手术修复，但初次手术后的自然外观不受影响。对于原发性隆鼻术，由于中间三分之一的系统修复或保留，没有因呼吸障碍而需要再次手术修复。
双鼻中隔支撑可以在与其他常规结构性移植物相同的条件下进行。作为一种多用途的替代方法，它可以与闭合或开放方法一起使用，并且仅需要使用有限量的软骨材料。这种解剖学方法可获得自然的效果，作为控制鼻尖形状、突出度和旋转度的基础。此外，无论是否使用“榫卯”技术或鼻尖移植物等补充技术，双鼻中隔支撑都可以被视为鼻尖手术的“多功能袖珍刀”。
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