Choi Jun Ho, Yoo Hyokyung, Kim Byung Jun
Department of Plastic and Reconstructive Surgery, Armed Forces Capital Hospital, Seongnam, Korea.
Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul, Korea.
Arch Plast Surg. 2021 Jan;48(1):3-9. doi: 10.5999/aps.2020.01088. Epub 2021 Jan 15.
For an attractive and natural tip contour in Asian rhinoplasty, insertion of a nasal implant and reinforcement of the cartilaginous framework are essential. However, scar contracture, which often results from augmentation with implant insertion and inadequate soft tissue coverage of the framework, is one of the most common causes of alar retraction. This study reports a novel method of redraping soft tissue along the alar rim to prevent alar retraction in Asians.
Twenty young Asian men who underwent primary rhinoplasty with septoplasty were retrospectively reviewed. After the usual rhinoplasty procedures, alar rim redraping was conducted for the soft tissue along the transcolumellar and bilateral infracartilaginous incisions. The longest axis of the nostril (a) and the height of the nostril from that axis (b) were measured in anterior-posterior and lateral views. The preoperative and postoperative ratios (b/a) were analyzed using the paired t-test.
All 20 patients showed natural contours of the nasal tip, nostrils, and alae after a mean follow-up of 53.6 weeks (range, 52-60 weeks). The ratio of the nostril axes significantly decreased postoperatively in all patients except one, by an average of 11.08%±6.52% in the anterior-posterior view and 17.74%±8.49% in the lateral view (P<0.01). There were no complications, including asymmetry, contracture, subdermal plexus injury, flap congestion, or infection.
A quantitative analysis of alar retraction by evaluating the ratio of nostril axes showed that alar rim redraping is a simple and effective adjuvant technique for preventing alar retraction in rhinoplasty for young Asian men.
在亚洲人鼻整形术中，为获得美观自然的鼻尖轮廓，植入鼻假体并加强软骨支架至关重要。然而，瘢痕挛缩是鼻翼退缩最常见的原因之一，这通常是由于植入假体及支架软组织覆盖不足所致。本研究报告了一种沿鼻翼缘重新塑形软组织以预防亚洲人鼻翼退缩的新方法。
回顾性分析20例行初次鼻整形术联合鼻中隔成形术的年轻亚洲男性患者。在常规鼻整形术后，沿鼻小柱及双侧软骨下切口对软组织进行鼻翼缘重新塑形。在前后位和侧位测量鼻孔的最长轴（a）以及从该轴测量的鼻孔高度（b）。采用配对t检验分析术前和术后的比例（b/a）。
所有20例患者在平均随访53.6周（范围52 - 60周）后，鼻尖、鼻孔和鼻翼均呈现自然轮廓。除1例患者外，所有患者术后鼻孔轴比例均显著降低，前后位平均降低11.08%±6.52%，侧位平均降低17.74%±8.49%（P<0.01）。未出现包括不对称、挛缩、皮下血管丛损伤、皮瓣充血或感染等并发症。
通过评估鼻孔轴比例对鼻翼退缩进行定量分析表明，鼻翼缘重新塑形是预防年轻亚洲男性鼻整形术中鼻翼退缩的一种简单有效的辅助技术。
