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KMID : 0358819860130040589
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Journal of Korean Society of Plastic and Reconstructive Surgeons
1986 Volume.13 No. 4 p.589 ~ p.592
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TURNOVER DEFORMITY OF THE IMPLANTED NASAL PROSTHESIS Case Report
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Kim Soo-Chul
Park Chong-Sup
Chang Sang-Suk
Ham Kee-Suk
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Abstract
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Turnover deformity means implanted nasal prosthesis turn over by external force or manipulation several months after Augmentation rhinoplasty. We recognized 3 cases of turnover deformity of the prosthesis recently. T재 was referred from outside and the one was our own surgical case. The cases referred from outside were 26 and 28 year old ladies who complained this deformity occured suddenly during or after cosmetic massage to the nose at the beauty saloon. Those patients have a history of the augmentation rhinoplasty performed 7 and 8 monthes ago by use of soft and straight type of nasal prosthesis. The smooth dorsum of the nose was changed suddenly to the broad angular surface after cosmetic massage. We carried out open reduction to correct this deformity. Cartilage over graft with non absorbable suturing on the tip of the prasthesis were performed to prevent this deformity as shown in fig 2.
The third case was a 24 year old man. He had augmentation rhinoplasty with soft and straight type of nasal prosthesis in our clinic 4 months ago for cosmetic reason. During an argument with his friend, the patient received several blows to his nose. Following this trauma his nose was swollen and severe bruise. After swelling subsided he noticed the deformity of his nose. Smooth dorsum was changed to a broad angular surface as result of nasal prosthesis turned over. We attempted closed reduction by external manipulation. The turned over prosthesis could be returned to original status by external manipulation. In the review of above 3 cases, we can recognize that the turn over deformity of implanted prosthesis could be caused by external trauma such as cosmetic massage and physical blowes not only by surgeon error, the possible mechanism of this deformity thought to be related to wider and more lubricated nasal pocket. We think the pocket is not formed evenly in all cases of the augmentation rhinoplasty as the same as ocurring in spherical contracture in augmentation mammoplasty. In some cases, a wider nasal pocket could be formed but other have a narrow pocket eventhough the same procedure is performed by same surgeon. The progression of this deformity seemed to originate from the distal portion of the prosthesis on bridge of the nose because of increased subsceptibility to trauma through the thinner skin in this area. It can be easily corrected by closed reduction with finger manipulation on the dorsum of nose.
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KEYWORD
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