口内双侧横行小切口隆颏术

目的:探求一种通过口内双侧横行小切口使假体置入更加方便准确、减轻术中损伤及术后并发症的隆颏手术新方法。方法:根据颏部解剖结构特点,采用口内双侧粘膜上横行小切口,切口定位于双侧尖牙下方距唇龈沟5mm处,长约8mm。横行切开粘膜及粘膜下组织,分别从两侧粘膜切口纵行向下钝性分离肌层至骨膜,用剥离子在骨膜下剥离拟置入假体腔隙,假体置入后肌层及粘膜分层缝合。结果:笔者采用该切口进行硅胶假体置入隆颏术共3例,切口均Ⅰ期愈合,未出现明显术后并发症。随访1～6个月,均获得满意效果。结论:采用经口内双侧横行小切口进行硅胶假体隆颏术对矫正McCarthyⅠ型轻度小颏畸形可获得满意术后效果,且保留颏部肌肉完整性并避开颏神经,创伤小,有利于减少术后并发症等优点。     

口内切口硅胶支架隆鼻术

目的探索和总结一种口内切口硅胶支架隆鼻术的方法.方法于口内的上唇系带唇侧根部1.5～2.0 cm处做横行切口,横穿口轮匝肌后,用钝头的弯剪刀从鼻棘前、鼻翼软骨的内侧脚间、鼻端部软骨浅层、鼻侧软骨背侧和鼻骨骨膜下至黄金点分离形成腔隙,然后置入硅胶假体.结果经临床36例患者手术观察,并随访3个月,对手术方法均满意,其中有3例患者因高度原因要求用此手术方法置换硅胶支架.结论口内切口硅胶支架隆鼻术其方法简单、不遗留鼻端和鼻孔缘瘢痕,是采用硅胶支架行隆鼻术的可取方法.     

口内切口硅胶支架隆鼻术

目的　探索和总结一种口内切口硅胶支架隆鼻术的方法。方法　于口内的上唇系带唇侧根部 1.5～ 2 .0cm处做横行切口 ,横穿口轮匝肌后 ,用钝头的弯剪刀从鼻棘前、鼻翼软骨的内侧脚间、鼻端部软骨浅层、鼻侧软骨背侧和鼻骨骨膜下至黄金点分离形成腔隙 ,然后置入硅胶假体。结果　经临床 36例患者手术观察 ,并随访 3个月 ,对手术方法均满意 ,其中有 3例患者因高度原因要求用此手术方法置换硅胶支架。结论　口内切口硅胶支架隆鼻术其方法简单、不遗留鼻端和鼻孔缘瘢痕 ,是采用硅胶支架行隆鼻术的可取方法     

Custom-designed chin augmentation

Although not devoid of complications, a properly performed chin implant surgery is a straightforward procedure that can correct a receding chin and enhance the results of other facial cosmetic procedures. In this article, the author reviews his technique over the last 18 years for augmentation mentoplasty using custom-designed Mersilene mesh implants.     

口内单侧纵切口e-PTFE隆颏术疗效观察

目的:阐述口内单侧纵切口e-PTFE隆颏术,观察其临床疗效。方法:对23例轻中度小颏畸形的患者,采用口内单侧纵切口,配合自制改良剥离子行e-PTFE隆颏术。结果:所有就医者随访6个月~2年,术后切口均一期愈合,无感染、假体排异、变形、移位等不良后果产生,外形满意。结论:口内单侧纵切口e-PTFE隆颏术是一种安全、有效、简便的纠治小颏畸形的手术方法。     

口内单侧侧方切口在隆颏术中的应用

目的:介绍一种适合使用假体隆颏的口内切口,以方便植入腔分离和假体植入,减少并发症,提高手术效果。方法:采用口内单侧侧方切口,即切口选择在右下2～3牙龈(左手操作者可将切口选择在左侧),距唇龈沟0.2～0.3cm处,长约0.5～1cm。采用局部麻醉。结果:自2003年11月至今,作者采用该切口行假体植入隆颏术18例,获得满意效果,未出现并发症。结论:采用口内单侧侧方切口行隆颏术,具有方便植入腔分离、假体植入、有利于减少并发症发生等优点。     

经腋下切口硅胶置入隆乳术的围手术期护理

目的:探讨我院行经腋下切口硅胶置入隆乳术的围手术期护理。方法:选择我院2008年12月～2011年10月在我院行硅胶置入隆乳术的患者24例,分别采取术前、术中以及术后护理,观察围手术期护理对隆乳术患者的临床护理作用;结果:24例行经腋下切口硅胶置入隆乳术的女性经手术后,均成功置入,置入后乳型丰满对称,无变性、炎症等不良反应,手术成功率100%;结论:完善的围手术期护理可以帮助患者今早的恢复,有助于患者的康复。     

经腋下切口硅胶置入隆乳术的围手术期护理

目的:探讨我院行经腋下切口硅胶置入隆乳术的围手术期护理。方法:选择我院2008年12月～2011年10月在我院行硅胶置入隆乳术的患者24例,分别采取术前、术中以及术后护理,观察围手术期护理对隆乳术患者的临床护理作用;结果:24例行经腋下切口硅胶置入隆乳术的女性经手术后,均成功置入,置入后乳型丰满对称,无变性、炎症等不良反应,手术成功率100%;结论:完善的围手术期护理可以帮助患者今早的恢复,有助于患者的康复。     

下颌骨侧位X线影像对隆颏硅胶假体选择和雕刻的指导作用

目的:数字化X线下颌骨侧位影像为隆颏术前硅胶假体的厚度选择提供评估依据.方法:32例隆颏患者术前拍摄线距离2米的数字化X线下颌骨侧位影像,分析软组织颏前点同鼻尖点和下唇中点连线之间关系.结果:软组织颏前点位于鼻尖最高点和和下唇中点连线的后侧.结论:数字化X线下颌骨侧位影像评估软组织颏前点位置对硅胶假体厚度选择具有指导意义.     

内镜辅助隆颏术临床观察

目的:探讨内镜在隆颏术中的临床应用价值。方法:口内下唇系带旁小直切口,不切断颏肌。在内镜辅助下,行颏前区骨膜下剥离,松解颏神经并予保护,在直视下植入多孔聚乙烯颏植入体,钛钉固定。本组共完成32例,均为先天性小颏畸形就医者。其中女25例,男7例,年龄18～45岁。结果:内镜完全可以清楚显示前颏和下颌体及颏神经,视野清晰,创伤小,无颏神经永久性损伤和下唇功能障碍。颏轮廓改善满意。结论:内镜辅助隆颏术有助于获得良好的手术效果。     

Oral animation in the decision for chin augmentation

Oral animation, such as opening and closing the lips, smiling, or laughing, leads to muscular tension over the skin and the soft tissues of the chin. The S-like labiomental line presents a variable scope of curves, from a full curve, through lazy-S, to a straight line. The different profiles of the chin thus achieved enable the plastic surgeon during preoperative planning to decide whether or not to perform chin augmentation in addition to the required rhinoplasty. Anatomical, functional, and clinical data are presented and discussed.     

Management and avoidance of complications in chin augmentation

Chin augmentation is an extremely rewarding cosmetic operation, particularly when performed as an adjunct to rhinoplasty and rhytidectomy. There has been much debate regarding the ideal surgical approach and whether implant placement or osseous genioplasty is the superior operation. Regardless of the technique, all surgery carries an inherent risk for complications, and it is the surgeon's responsibility to learn which techniques will work best in his or her hands for each patient. Certain complications can be almost unavoidable, but a solid foundation in anatomy and a review of the existing literature can help minimize the risk of certain problems while providing an improved understanding of how to recognize and manage them when they occur. The authors present a comprehensive review of genioplasty and chin implant complications, how they might be avoided, and management methods if they occur.     

硅橡胶假体植入阴茎增粗术

目的：介绍一种操作简便、损伤小的阴茎增粗术。方法：用硅橡胶假体植入Buck筋膜下行阴茎体前部增粗术。结果：本组47例患者大部分术后性生活明显改善，夫妻双方满意。有1例术后性生活过旱，伤口破溃，取出假体。结论：用硅橡胶假体行阴茎体前部增粗是一种操作简单、恢复快、效果良好的阴茎增粗手术。     

Transareolar incision for augmentation mammaplasty

In the past, unacceptable results were obtained in attempts to correct hypoplastic breasts, so that patients seeking augmentation mammaplasty were afraid of possible hazards. Silicone inclusions were a great advancement in biological engineering. Their implantation through the transareolar incision by Pitanguy seems to be more physiologic and gives welcome aesthetic resuls. Furthermore, the incision allows adequate undermining and good hemostasis. Because there is no inframammary scar and consequent tissue weakness, early mobilization of the prosthesis by precocious manipulation is possible, decreasing the occurrence of capsule formation.Professor of Plastic Reconstructive Surgery at Catholic University of Rio de Janeiro, Chief of the Plastic Department at the 38th. Infirmary of the Santa Casa de Misericórdia General Hospital, and Member of the National Academy of Medicine.     

Mersilene mesh chin augmentation. A 14-year experience

During the past 20 years, a variety of alloplastic materials have been introduced for chin augmentation. Mersilene mesh (Ethicon, Sommerville, NJ), introduced in 1950, demonstrates many qualities that make it an ideal implant. This article reviews the senior author's (S.W.P.) successful 14-year experience using Mersilene mesh chin implants. Between 1983 and 1997, 264 patients underwent chin implantation procedures. The results show a low rate of infection (0.8%) and displacement (1.5%). There were 14 temporary paresthesias and no cases of permanent anesthesia. There were no incidences of absorption, rejection, or extrusion. Mersilene provides a soft, natural appearance to the chin, and it continues to be our choice for chin implantation.     

Transaxillary endoscopic silicone gel breast augmentation

Following the return of silicone gel breast implants to the US market in 2006, augmentation with these implants has become increasingly popular. Surgeons have an array of refined techniques from which to choose when performing these procedures, many of which offer the advantage of reduced or less-obvious postoperative scarring. For obvious reasons, many patients are requesting placement of the implants through incisions that are removed from the breast area (and thereby hidden). The challenge of these approaches is to provide a level of technical control that matches what is afforded with the traditional inframammary approach. The addition of endoscopic assistance has provided a level of tissue visualization and technical control not previously possible with the transaxillary approach, with results that rival those of an inframammary procedure. In this article, the author presents his current operative technique, which has allowed for the routine placement of silicone gel breast implants through a transaxillary incision using endoscopic assistance.     

Nasal dorsal augmentation with silicone implants

Silicone rubber has been used safely and effectively for facial augmentation for nearly 5 decades in eastern Asia. We have used silicone rubber nasal implants in primary ethnic rhinoplasty and have found consistent and long-lasting results with low complication rates. Silicone dorsal nasal augmentation in primary rhinoplasty avoids donor site morbidity and implant resorption as seen with autogenous implants. Silicone nasal implants have a low extrusion and infection rate. In the appropriate patient with proper placement, silicone nasal implant is nearly the ideal implant material.     

自体下颌角骨质游离移植隆颏术的实验和临床研究

目的:研究应用自体下颌角区骨质游离移植隆颏术的可行性。方法:分为两部分,第一部分动物实验:将小型猪的下颌角截除,并用截除的下颌角骨质移植到颏部,用钛钉固定,术后用三维CT进行效果评定。第二部分,临床应用,在46例应用双侧下颌角截骨术治疗方脸畸形的同时,应用下颌角骨质进行隆颏术,术后随访,观察治疗效果。结果:动物实验中游离移植的骨质完全被吸收。临床病人中73.9%的患者吸收率达到50%以上。结论:通过动物实验和临床应用观察,我们认为临床中应用下颌角截除的自体骨游离移植隆颏术需要谨慎实施。