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KMID : 1160320190030010040
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Journal of Cosmetic Medicine
2019 Volume.3 No. 1 p.40 ~ p.48
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Revision rhinoplasty for contracted nose in Asia
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Vo Huy Tien
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Abstract
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Contracted nose is a deformity, occurring both internally and externally, of the nose due to scar tissue contraction or capsular formation after repeated rhinoplasties using silicone implants. To comprehensively address the issue, the following surgical techniques were chosen: releasing capsular contracture by dual plane dissection when undermining the skin, and elongating the framework by septal extension graft or autogenous rib cartilage graft. From 2013 to 2017, 253 patients with contracted nose underwent combined procedures: dual plane dissection, extended spreader graft & caudal septal extension graft, total septal reconstruction by autogenous rib cartilage, tip repositioning and tip grafts, and dorsal augmentation. Satisfactory results were obtained in 240 (95%) patients. The results included extended skin and lengthened alar cartilage, elongated framework, and lengthened and projected nasal tip. Thirteen patients (5%) who underwent short-nose correction required revision surgeries because of overcorrection or undercorrection of nasal length, poor tip projection, or inadequate correction of columellar retraction. The length of the nose could be extended by dual plane dissection to release adhesion of skin and scar tissue, extended spreader grafting, dorsal augmentation, and tip and alar grafting. The goal of surgery is to use to use a combination of techniques to achieve the aesthetic goals for both patients and surgeons.
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KEYWORD
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combined procedures, contracted nose, revision rhinoplasty, rhinoplasty
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