The Use of High-Density Porous Polyethylene as a Custom-Made Nasal Spreader Graft

The concept and technique of using high-density porous polyethylene (HDPP), a nonresorbable synthetic material, for nasal spreader grafts, are presented. This material is thought to be particularly useful in revision (secondary or tertiary) rhinoplasty, in which internal valve collapse frequently is confronted and septal cartilage often is unavailable because it has been harvested for spreader or other grafts. Sold as a thin plain sheet (0.85 × 38 × 50 mm) that can be cut to an appropriate size for spreader grafts, HDPP is a ready-to-use material commercially available on the market. Because HDPP permits ingrowths of fibrous tissue inside and around, it is a nonabsorbable material that stabilizes the upper lateral cartilages in their new position and maintains the appropriate internal valve angle. The authors used this material for 15 patients undergoing secondary (n = 12) and tertiary (n = 3) rhinoplasty because of valvular collapse. During the mean follow-up period of 16 months (range, 8–30 months), neither complication nor recurrence of airway obstruction occurred. Presented as a free paper at the 4th National Aesthetic Plastic Surgery Meeting of the Turkish Republic of Northern Cyprus, 22–26 June 2005, Kyrenia, TRNC     

74例隆鼻后并发症病因及处理探讨

回顾近１０年对７４例隆鼻术后并发症病人的处理，将隆鼻术后常见并发症分为７类。从临床角度分析了７类并发症发生的可能性原因，并相应处理。其中假体浅化问题随着临床病例数的增加及随访时间的延长，已变得日渐明显，除部分是由术者技术原因引起，更多的可能与其它因素有关。低毒性感染和免疫排异反应，临床诊断较难区分，但其临床表现相似，处理方法类同。通过对隆鼻术后并发症原因的分析，揭示了隆鼻术存在的问题，以引起足够的重视     

The bilateral conchal cartilage graft: A new technique in augmentation rhinoplasty

The most common procedures to reconstruct a severe saddle-nose deformity are autogenous costal cartilage, iliac bone grafting, or Silastic implants. Each of them has its specific disadvantages. As an alternative solution, an autogenous bilateral conchal graft in sand-wich technique is described. A 3-layer graft for the dorsum and a 2-layer graft to support the depressed columellar-tip area grants a more natural and elastic reconstruction of the nasal framework. The conchal grafts are taken by an incision made on the preauricular surface of the ear. How to plane the curved grafts by meticulous cross-hatching and to immobilize them in the recipient area by transcutaneous suturing is demonstrated.Presented at the VIII International Congress of Plastic and Reconstructive Surgery, Montreal, Canada, June, 1983     

Technique of split skin graft fixation using hypafix: a 15-year review

The technique of graft fixation with Hypafix was introduced in 1986 and has since been adapted for use in all sites to become the standard technique in the management of paediatric burns at the Women's and Children's Hospital Burn Unit. The technique is versatile, safe, simple, reliable and inexpensive, and has proven to be effective in over 700 burn patients, with 18 patients (2%) requiring repeat grafts. The patient's care is continued in a designated Burn Scar Assessment Clinic with a range of 'contact media', including Hypafix, Elastofix, silicone gel and Elastomer products, being applied as necessary.     

Correction of mild and moderately collapsed nose in leprosy patients using a metatarsal corticoperiosteal bone graft

Summary Twenty-four leprosy patients having mild and moderate collapse of the nose were operated using a corticoperiosteal graft from second metatarsal bone. The graft was placed in a pocket created between the lining and cover of the nose. The details of the technique and postoperative care have been described. Early postoperative problems have been discussed.     

隆鼻术后并发感染误诊为排斥反应原因分析与处理

报告用固体硅胶隆鼻术后，因鼻部出现红肿与积液被诊断为“排斥反应”而摘除鼻支架的２５例求术者，经作者再次行隆鼻术后，手术成功２４例，失败１例（为术后出现血肿）。认为本组既往以“排斥反应”诊断有误，上述表现系感染所致，并对其误诊的原因进行了分析，对感染与排斥反应的鉴别提出初步意见。     

长盾形和多层盖板耳廓软骨移植物在鼻尖整形中的应用

目的:探讨长盾形和多层盖板耳廓软骨移植物在鼻尖塑造中的应用。方法:在分离、修整、缝合下外侧软骨穹窿部的基础上,于耳后颅耳沟切口切取耳廓软骨,修剪成长盾形及2~3块盖板移植物,用于鼻尖的塑形。结果:共11例患者,随访时间6~24月,效果满意,无严重并发症发生。结论:长盾形和多层盖板耳廓软骨移植物可以良好的修饰鼻尖,取材方便,操作简单,效果肯定。     

牙槽裂植骨同期鼻中隔骨支架植入鼻整形术

目的　研究在牙槽裂植骨修复的同时 ,利用自体髂骨皮质板块 ,修复单侧唇腭裂鼻畸形。方法　 10岁以后的单侧完全性唇腭裂患者 ,采用自体髂骨松质骨移植修复牙槽裂 ,同时采取髂骨内侧骨皮质修整后植入两侧鼻翼软骨内侧脚之间 ,形成鼻中隔前下部的骨性基础支架 ,将分离复位的鼻翼软骨内侧脚提升 ,使软骨穹窿顶超过骨性支架的上缘约 3mm ,将软骨缝合固定于骨性支架。结果　本组 2 4例患者均一期痊愈出院 ,患侧鼻翼基部凹陷、鼻小柱偏斜、鼻尖低平等畸形得到良好的矫正。结论　牙槽裂植骨与鼻畸形整复同期进行互不干扰。鼻中隔前骨性支架对鼻的外形结构有良好的支持作用 ,可以有效地矫正唇腭裂鼻畸形 ;与牙槽裂植骨同期进行 ,取材方便 ,减少了手术及麻醉的次数。     

Conclusions after 122 revision rhinoplasties: Brief review of cases

Revision rhinoplasty is always more complicated than the primary surgery. A more conservative approach using safer, more reliable techniques in primary surgery should decrease the number of revisions.     

Blepharoplasty to form the orbitopalpebral sulcus and nasal bone graft in oriental subjects (Occidentalization)

The procedures of blepharoplasty and rhinoplasty have been applied successfully, alone or in combination, to the occidentalization of Oriental patients for aesthetic reasons. The blepharoplasty, using the Sayoc-Millard technique, and the rhinoplasty, using an autogenous osteoperiosteal graft from the crest of tibia, are described in detail.Work presented at the XVI Congresso Brasileiro de Cirúrgia Plástica (Brazilian Congress of Plastic Surgery), December 2–8, 1979, Guarujá, São Paulo, Brazil. Work performed at the Plastic Surgery Unit, Clínica de Cirúrgia Plástica Dr. Oswaldo de Castro, São Paulo, Brazil.     

Dissection of the medial crura as a standard procedure in rhinoplasty: Case studies

In the systematic approach to rhinoplasty, the author routinely uses an intercartilaginous columellar incision for dissection and reconstruction of the nasal tip, especially to facilitate separation of the tip cartilages from other tissues in the lower third of the nose. This technique has been used by the author for more than ten years and its advantages are demonstrated.