美容性短鼻延长术

Aesthetic lengthening procedure for foreshorted nose

目的探讨美容性短鼻延长术的安全性及有效方法。方法采用自体鼻中隔软骨扩展移植与膨体聚四氟乙烯置入的方法，重建鼻下部的支撑结构，使鼻尖获得足够的向前下方的支撑力，增加了鼻背长度并纠正了鼻尖上旋，同时行“盾牌状”“帽状”移植，以进一步突出鼻尖的形态。结果36例美容性短鼻者术后形态满意，鼻背已延长，鼻尖上旋纠正，鼻唇角正常。随访所有求美者6～12个月，鼻尖部形态稳定，但有3例鼻小柱轻度偏斜，无其他并发症。结论美容性短鼻的延长，需要强有力的向前与向下方的支撑力，必须重建鼻下部的支撑结构，才能得到有效矫正。“盾牌状”“帽状”软骨移植可进一步提高矫治效果。

Objective To investigate a safe and effective method of aesthetic lengthening procedure for foreshorted nose. Methods The extended grafts of autologous nasal septal cartilage and implant of extended polytetrafluoroethylene （ePTFE） were adopted to reconstruct the supporting structures of nasal inferior part to increase the downward and forward supporting power of the nasal tip improve the length of nasal dorsum and cor- rect the topspin of nasal tip. The shield-shaped and cap-shaped grafts were also used to make further improve- ment for the contour of nasal tip. Results Thirty-six cases with foreshorted nose who undergone the aesthetic lengthening procedure were satisfied with the lengthened nasal dorsum, corrected topspin of nasal tip and normal nasolabial angle. After 6 to 12 months following up, all the shapes of nasal tips were stable except for 3 cases with mild asymmetry of nasal columella, there were no complications occurring. Conclusion For obtaining the effective correction of foreshorted nose by the aesthetic lengthening procedure, providing of powerful forward and downward supporting and reconstruction of the supporting structures of nasal inferior part are necessary and the use of the shield-shaped and cap-shaped grafts can make further improvement for the contour of nasal tip.