Ors Safvet
SO-EP Aesthetic and Plastic Surgery Clinic, Kayseri, Turkey.
Plast Reconstr Surg Glob Open. 2020 May 14;8(5):e2809. doi: 10.1097/GOX.0000000000002809. eCollection 2020 May.
Combined cosmetic surgeries are advantageous to patients, requiring only 1 anesthesia administration and the loss of fewer working days. There is no previous study reporting on a submuscular implant placement with the simultaneous reconstruction of a nose deformity using a rib graft. Reconstructions of nose deformities through a rib graft, augmentation mammoplasty, and augmentation mastopexy were performed on 4 female patients (who were 19, 23, 24, and 27 years old) between 2006 and 2016. The patients were taken for operations under general anesthesia. First, the rib graft was taken and the breast implant was placed to prevent contamination. An inframammary incision was made, the skin and the subcutaneous layers were passed, and the pectoral muscle fascia was accessed for the rib graft in all 3 patients. After the perichondrium was dissected, an osteochondral graft was harvested at full thickness. The remaining sharp edges were rasped to avoid damaging the silicone. The perichondrium and the periosteum were sutured edge-to-edge, and the donor area was closed. The harvested grafts were used to produce a spreader graft, a nasal valve graft, an onlay graft, and an L-strut graft. In the early period, no seroma, hematoma, or infections were experienced. There were no ruptures, leakages, capsules, or deformities during the 2- to 10-year follow-up. Primary and secondary rhinoplasties requiring a rib graft can be safely performed simultaneously with a breast implant, provided that the rib stumps are closed with a thick protective layer.
联合美容手术对患者有利，只需要一次麻醉，且减少工作日的损失。以前没有研究报道过采用肋软骨移植同时进行鼻畸形重建的肌下植入物放置情况。2006年至2016年期间，对4名女性患者（年龄分别为19岁、23岁、24岁和27岁）进行了通过肋软骨移植进行鼻畸形重建、隆乳术和乳房上提隆乳术。患者在全身麻醉下接受手术。首先，获取肋软骨移植并放置乳房植入物以防止污染。所有3名患者均采用乳房下切口，切开皮肤和皮下层，进入胸肌筋膜获取肋软骨移植。解剖软骨膜后，全层获取骨软骨移植。将剩余的尖锐边缘锉平以避免损坏硅胶。将软骨膜和骨膜边缘对边缘缝合，关闭供区。获取的移植组织用于制作撑开移植、鼻瓣移植、嵌体移植和L形支柱移植。早期未出现血清肿、血肿或感染。在2至10年的随访期间，未出现破裂、渗漏、包膜或畸形。如果用厚的保护层封闭肋骨残端，需要肋软骨移植的一期和二期鼻整形术可以与乳房植入物安全地同时进行。
