The advantages of self tissue augmentation rhinoplasty

Dr. Chang has been doing rhinoplasty with self tissue since nearly 20 years ago. Example 1 is Mrs. Chang whose nose was done by Dr. Chang in 1989.

Example 1

Figure 1: Before surgery. Figure 2: Augumentation rhinoplasty with Implant + ear cartilage in the tip of her nose, 12 days after. Figure 3: 11 years follow up. ( Please note: Cosmetic philtrumplasty was perfomed at the same time.)

Example 1 14 years follow up

說明:從上圖三張追Figure1: 11 years after augmentation rhinoplasty with implant + tip cartilage.

Figure 2: Capsular contracture developed 14 years after rhinoplasty .

Figure 3: After self tissue augmentation rhinoplasty, the implant in her nose was completely replaced with self tissue.



Example 2 : Augmentation rhinoplasty with nasal septal cartilage done elsewhere and seeked for revision.

Reshaping of the previously implanted septal cartilage and put onlay cartilage from rt. ear.

Example 2 Oblique views

Lt. Unnatural looking of nasal bridge at supratip portion noted . Rt. after revision.


Example 2 Lateral views

Onlay cartilage graft at the tip before and after surgery.

張醫師你好:我的鼻子其實是長得不錯的,好多朋友都覺得我那個是富貴鼻,側面看是挺高的!可是每當正面看的時候,山根的地方就不見了, 真的不明白為什麼?我自已常常希望能找出問題來,就是找不出來!我想問,假如我只在鼻樑的位置隆鼻,是否都可以嗎?還有請問醫師會用什麼材料去隆呢?是一 輩子的嗎?那鼻頭方面會會怎樣呢,鼻樑的材料會從鼻頭穿出嗎?還有價錢方面大概要多少?幾天會復完呢?問題蠻多的,真的不好意思!謝謝!


自體組織隆鼻,可調整美化不平整地形

鼻樑、鼻根處的凹陷或不平整情形,如果考慮隆鼻,那麼毫無疑問的,自己的耳朵軟骨,絕對是最好的選擇。原因呢?

1.任何人工鼻模,無論採用多麼精細的手法雕刻,都非常困難做到與鼻根的骨骼100%緊密接觸黏合,耳朵軟骨則沒有這個顧慮。

2.鼻子本身的骨骼會生長改變,即使在手術後,人工軟骨看似與鼻骨契合,經年累月之後,與人工軟骨之間的"默契"往往會變差。耳朵軟骨則會與鼻樑長在一起,將來不會移動到別處。

3.不論是矽膠或是Gortex所製作的人工鼻模, 隆鼻以後長年追蹤,經常都會發生程度不等的莢膜收縮問題,耳朵軟骨或是其他自體組織隆鼻,則完全不會有這樣的顧慮。

案例一:鼻根凹陷,以耳朵軟骨填補,微量隆鼻後立刻照相

說明:左圖為手術前照相,右圖則為手術後立刻照相。手術內容:經由右側鼻孔內微小切口,植入耳朵軟骨,鼻孔內切口,本案例手術切口沒有縫合,也不必拆線。右圖為手術後立刻照相,鼻根處的藍色痕跡,為手術前定位記號。

案例一: 術前與術後追蹤照相

說明:

左上圖:手術前正面照相

右上圖:術前以手術用筆,畫出準備植入耳朵軟骨部位與範圍

左下圖:手術經由右側鼻孔,植入耳朵軟骨後立刻照相

右下圖:術後三天照相

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