Fung Chak Yuen, Kim Jeong Heon, Liao Pei-Hsun, Jang Yong Ju
Aesthet Surg J. 2023 Oct 13;43(11):1237-1247. doi: 10.1093/asj/sjad180.
Complicated silicone nose is a common clinical problem. Selection of replacement material for revision dorsal augmentation is a challenging task.
The authors presented their experience in the use of molded glued diced cartilage graft (GDCG) for revision rhinoplasty in patients who had complicated silicone augmentation.
The authors performed a retrospective review of the medical records of 28 patients who underwent silicone implant removal and revision dorsal augmentation with costal cartilage at a tertiary center between February 1, 2018, and February 28, 2022. Patient demographics, surgical technique, anthropometric measurements, and complication data were retrieved and analyzed. Aesthetic outcome scoring and anthropometric measurements were performed.
Twenty-eight patients (9 males and 19 females) who underwent revision rhinoplasty with augmentation were reviewed. The principal indication for revision was cosmetic dissatisfaction. Mean postoperative follow-up duration was 18.3 months. All patients had revision dorsal augmentation with molded GDCG. Other key surgical techniques include the use of caudal septal extension and extended spreader and tip grafts. The majority of the patients were judged to have good or excellent outcomes (91.1%). There were significant percentage increases in dorsal height, radix height, nasal length, and nasal tip projection (2.78%, 2.26%, 7.53%, and 2.40%, respectively; P < .05) and reduction of nasal axis deviation of 1.15° (P < .05) postoperatively. Two patients had postoperative complications, including infection and cosmetic dissatisfaction.
Revision rhinoplasty following unsuccessful silicone augmentation is commonly encountered in the Asian population. Molded GDCG for revision dorsal augmentation is a reliable option that delivers good to excellent aesthetic outcomes with acceptable complication rates.
复杂硅胶鼻是常见的临床问题。选择用于修复隆鼻术的替代材料是一项具有挑战性的任务。
作者介绍了他们在使用模制胶合碎软骨移植（GDCG）对硅胶隆鼻术复杂的患者进行鼻整形修复中的经验。
作者对2018年2月1日至2022年2月28日期间在一家三级中心接受硅胶植入物取出及肋软骨修复隆鼻术的28例患者的病历进行了回顾性研究。收集并分析了患者的人口统计学数据、手术技术、人体测量数据和并发症数据。进行了美学结果评分和人体测量。
对28例行隆鼻修复术的患者（9例男性和19例女性）进行了回顾。修复的主要指征是对外观不满意。术后平均随访时间为18.3个月。所有患者均采用模制GDCG进行修复隆鼻。其他关键手术技术包括使用鼻中隔尾端延长、延长撑开器和鼻尖移植。大多数患者被判定为效果良好或极佳（91.1%）。术后鼻背高度、鼻根高度、鼻长度和鼻尖突出度分别显著增加（分别为2.78%、2.26%、7.53%和2.40%；P < 0.05），鼻轴偏斜度降低1.15°（P < 0.05）。两名患者出现术后并发症，包括感染和外观不满意。
硅胶隆鼻失败后的鼻整形修复术在亚洲人群中很常见。模制GDCG用于修复隆鼻是一种可靠的选择，可带来良好至极佳的美学效果，并发症发生率可接受。
