Daniel R K
Division of Plastic Surgery, University of California Irvine, USA.
Plast Reconstr Surg. 1995 Dec;96(7):1539-46. doi: 10.1097/00006534-199512000-00005.
On the basis of 56 cases of secondary rhinoplasty following an initial open rhinoplasty, I conclude that secondary surgery is safe and effective. Either an open or closed approach can be used in most cases with little risk of skin necrosis or poor scar formation. The decision as to which approach to use depends on numerous factors. In general, a closed technique is favored when augmentation is the solution, while an open technique is favored when structural correction is required. Reopening the nose was done consistently without problems but was avoided in two patients because of severe thinning following previous defatting. However, certain "stigmata" were seen following open primary rhinoplasty and should be avoided: (1) a depressed, visible scar, (2) destruction of the soft-tissue facets and nostril apices, (3) columella deformities with associated nostril asymmetry, and (4) excessive tip or supratip defatting.
基于56例初次开放式鼻整形术后二次鼻整形的病例，我得出结论：二次手术是安全有效的。在大多数情况下，开放式或封闭式入路均可采用，皮肤坏死或瘢痕形成不良的风险很小。采用哪种入路的决定取决于众多因素。一般来说，当以隆鼻为解决方案时，倾向于采用闭合技术，而当需要进行结构矫正时，则倾向于采用开放技术。重新打开鼻子的操作一直没有问题，但有两名患者因之前抽脂后严重变薄而未进行。然而，初次开放式鼻整形术后会出现某些“体征”，应予以避免：（1）凹陷、可见的瘢痕；（2）软组织小平面和鼻孔尖的破坏；（3）伴有鼻孔不对称的鼻中隔畸形；（4）鼻尖或鼻背过度抽脂。
