再次隆鼻的手术时机选择

Optimal timing of secondary augmentation rhinoplasty

目的 隆鼻手术失败取出假体按传统方法需 3个月以后才能行再次隆鼻术 ,患者往往难以接受。该研究观察假体取出后同时进行隆鼻的临床效果 ,并就隆鼻失败的常见原因、表现形式及具体处理措施进行了详细探讨。方法 通过隧道剥离层次的改变、导引器的使用、缝线或印膜外固定、高质量隆鼻材料 ,以及材料形态的改变等措施对 79例患者进行了假体取出后即刻隆鼻术。结果 经过 3个月至 5年的随访观察 ,除 3例肿胀消退时间较长以外 ,其余患者都取得了满意的手术效果。结论 采取一些措施后 ,隆鼻失败假体取出即刻行隆鼻术可以取得与传统手术方法同样的临床效果 ,但它减少了手术次数和费用 。

Objective The secondary augmentation rhinoplasty is usually performed at least 3 months after the removal of implants because of dissatisfied appearance, which is hardly acceptable to most of patients.This study is to observe the effect of immediate nasal augmentation after taking out the undesirable implants. Methods With the fixation of suture and dental rubber cast, use of high quality of nasal implant inducer, changing of lamina of implant room, and changing of implant shape, 79 nasal augmentation operations were performed in the meantime of implant removal. Results Follow-up varied from 3 months to 5 years, and all cases obtained satisfactory results functionally and esthetically except 3 cases experiencing relative long time of nasal ecchymoses. Conclusion Immediate nasal augmentation after removal of undesirable implants can obtain the same functional and aesthetical results as traditional method, and it reduces the operation times and the expenditure of patients. It is more easily acceptable to many patients. Failure causes and manifestations of augmentation rhinoplasty and details in handling have been discussed.