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KMID : 0358819880150010065
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Journal of Korean Society of Plastic and Reconstructive Surgeons
1988 Volume.15 No. 1 p.65 ~ p.70
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A CLINICAL STUDY ON THE MECHANISM OF THE CURVED DEFORMITY OF IMPLANTED NASAL PROSTHESIS
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윤정길/Yoon, Chung Gil
박종섭/조대환/함기선/Park, Chong Sup/Cho, Dae Whan/Ham, Kee Sun
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Abstract
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Sometimes we encounter complications such as skin problems, infection, protruding prosthesis, deviated prosthesis, turnover deformity or curved deformity and others that can be caused by silicon implanted augmentation rhinoplasty. Among those complications the curved deformity is one of the most annoying problem to the patient and surgeon.
The curved deformity means an appearance of the axially curved deviation on the dorsum of the nose associated with skin erythema and supratip deformity after an augmentation rhinoplasty. We experienced 6 cases of this kind of deformity over the past 4 years. 2 were referred to us by other surgeons and 4 were from our own surgical cases.
All of our cases had augmentation rhinoplasty implanted with a soft type of prosthesis (®koken) and the referred cases used an medium type (®Dow corning).
There was a period of satisfying results from 3 to 4 months after surgery however a gradual appearance of the typical deformities occurred. Even after the second surgery for the correction of the first deformities, there was a even shorter period of satisfaction which lasted only 2 to 3 months.
Therefore we suppose this deformity is caused by an inproportional contracture of the surrounding capsule. Through the microscopic studies of the histological structure of the capsule between the tip and the paranasal area. We got the following findings, the area around tip showed more of an inflammatory reaction with a marked lymphohistiocyte infiltration and a fibrous thickening of the capsule. There was no evidence of a fibrous membrane between the silicon and the capsule. In the paranasal area we noticed a less inflammatory reaction and an obvious fibrous membrane between the silicon and the capsule. The surrounding fibrous capsule was composed of a hyalinized connective tissue in
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