Tebbetts J B
Division of Plastic and Reconstructive Surgery, University of Texas Southwestern Medical Center, Dallas, USA.
Clin Plast Surg. 1996 Apr;23(2):245-53.
Historically, destructive tip-shaping and positioning techniques, although effective to some degree, have created large numbers of secondary deformities. Tip grafts, necessary in secondary rhinoplasty, have been applied widely in primary rhinoplasty, introducing additional variables and a significant reoperation rate. Nondestructive tip-shaping and positioning techniques offer the surgeon a wider range of alternatives, more control and predictability, and a lower reoperation rate. We are making major changes in the way we think about primary tip rhinoplasty. Most importantly, we are learning (or relearning) that preservation of normal anatomy and structural integrity is a surgical principle epitomized in primary rhinoplasty, and that when we can achieve the desired result using that normal anatomy and preserving its structural integrity, the long-term result is more predictable.
从历史上看，尽管有一定效果，但具有破坏性的鼻尖塑形和定位技术造成了大量继发性畸形。在二次鼻整形术中必需的鼻尖移植，已在初次鼻整形术中广泛应用，带来了额外的变量和显著的再次手术率。非破坏性鼻尖塑形和定位技术为外科医生提供了更广泛的选择、更多的控制和可预测性，以及更低的再次手术率。我们对初次鼻尖鼻整形术的思考方式正在发生重大变化。最重要的是，我们正在学习（或重新学习），保留正常解剖结构和结构完整性是初次鼻整形术中体现的一项手术原则，并且当我们能够利用该正常解剖结构并保持其结构完整性来实现预期效果时，长期效果更具可预测性。
