颗粒脂肪移植在伴有双颌前突的鼻颏美容整形中美学形态掩饰的实现

Aesthetic camouflage with granular fat transplantation in rhinoplasty and chin augmentation with bimaxillary protrusion

目的探讨以应用自体肋软骨移植矫正鼻畸形为核心,联合自体颗粒脂肪行面部填充术+假体隆颏术,矫正视觉上骨性双颌前突面部畸形的效果。方法对11例确诊面部骨性双颌前突畸形的患者采用3项手术联合的方案进行面部畸形矫正,即自体肋软骨鼻畸形矫正术、颗粒脂肪面部填充和假体隆颏术。切取左侧第7肋软骨矫正鼻畸形,增加鼻背高度和鼻尖突出度;取大腿外侧皮下自体脂肪纯化离心后,填充矫正面部凹陷;硅胶假体填充下颏矫正颏后缩。结果本组11例患者获术后随访6～18个月,所有患者的骨性双颌前突的缺陷在视觉上均获得了矫正,同时鼻畸形及下颏后缩也得到明显改善,获得了较和谐的鼻、唇、颏之间的关系,面部整体美观协调性得到了较大的提升。患者对效果均较满意。结论以应用自体肋软骨矫正鼻畸形为核心的面部轮廓调整,联合自体颗粒脂肪面部填充术+假体隆颏术,可以在视觉上显著改善骨性双颌前突,实现新的面貌美学平衡,效果可靠,具有一定的临床应用价值,为改善骨性双颌前突的面部畸形提供了一种新思路。

Objective Taking correction of nasal deformities with autologous costal cartilage as the basis of our study, our objective is to explore the efficacy of autologous granular fat transplantation combined with rhinoplasty and chin augmentation in correcting bimaxillary protrusion for facial aesthetic balance. Methods Correction of nasal deformity with autologous costal cartilage combined with granular fat transplantation for facial filling and chin augmentation was performed in 11 patients diagnosed with facial bimaxillary protrusion deformity. The left 7th costal cartilage was cut toachieve the height ofthe nasal dorsum and the projecting degree ofthe nasal tip. After purification and centrifugation of autologous subcutaneous fat from the lateral thigh, facial depression was improved. Chin retraction was corrected by chin augmentation with silicone gel prosthesis. Results All patients were followed up from 6 to 18 months. The bimaxillary protrusions were corrected and nasal deformities and chin retraction were remarkably modified. Patients were satisfied with the postoperative outcome and a harmonious relationship was achieved among the nose, lip and chin, exhibiting a good facial aesthetic balance. Conclusion Application of autologous costal cartilage in correction of nasal deformity combined with autologous granular fat for facial filling and chin augmentation could significantly improve bimaxillary protrusion. The effect was reliable and achieved a new aesthetic balance. It had certain clinical application value and provided a newmethod for the treatment ofbimaxillaryprotrusion.