※ Two-pieces of augmentation rhinoplasty (兩段式隆鼻手術)
※ Korean-way of augmentation rhinoplasty(韓式隆鼻手術)
Rhinoplasty is a highly specialized field that requires much knowledge and skill on the surgeon to have successful result .The concepts of beautiful nose are different from Asians and Caucasians with respect to ethnic and cultural backgrounds, anatomy of the face and nose, and psychological and aesthetic needs of the patients . Asian rhinoplasty is one of the most common aesthetic procedures in Taiwan. The specialty of Asian rhinoplasty surgery has grown and evolved with the refinement of many innovative techniques and the creation of new procedures.
Orientals have flatter noses than Caucasians because of insufficient bone and cartilage support for oriental nose. The common complaints told by orienta patients are bulbous tip, wide and low dorsum, retracted columella, flat nostril, weak and thin cartilage, and thick skin (thick subcutaneous tissue). We can divide the oriental noses problems into 5 groups:
short nose, bulbous nose, saddle nose, retracted columella, and insufficient nasal tip projection.
For the augmentation of oriental nose, alloplastic material (L-shape silicone) have been widely used for more than 30 years. Therefore secondary revision procedure is also increased because L-silicone implant are prone to exposure, infection, and displacement . And also in case of lack of skin envelope and short nasal framework , it is not enough to get good result by performing augmentation using L-shape silicone implant . Inadequate surgical technique and overaggressive augmentation with silicone implants have led to the potential of implant extrusion through the incision site, or, worse yet , through the overlying tip skin.
The complications following L-shape silicone implantation include
- Infection
- Dislocation
- Mobility of silicone
- Extrusion of silicone ( with L –shape silicon prosthesis )
- Hematoma
- Seroma
- Nasal skin changes ( contractures of nasal tip , intermittent erythematous discoloration )
- Transparent dorsal skin
- Glistening of dorsal skin
I often meet the patients with dislocation of nasal tip to one side, or even extrusion of implant after L-shape silicone augmentation rhinoplasty
Which method is good for oriental nose? The critical points of decision for Asian rhinoplasty are selecting appropriate grafting material, control of nasal tip projection, and precise control of dorsal height. In my opinion, the best way for the augmentation of oriental noses is the Two-pieces of augmentation rhinoplasty, i.e. the Korean way of augmentation rhinoplasty . The surgical methods are I-shape silicone or Gortex for radius and dorsum, septal cartilage graft for columella support, and dome suture and ear cartilages for tip projection. I would like to use rib cartilages in some special and difficult cases. So I will talk to my patients that the two-pieces augmentation rhinoplasty ( i.e. the Korean way of augmentation rhinoplasty) is the sculpture of nose individualized! And now the autogenous cartilages ( septal , auricular, rib cartilages ) and alloplastic materials ( I-shape silicone, Gortex) have been widely used !
The suggested time schedules for patients that do not live in Taiwan :
Day1 (on arrival): consultation
Day 2 (operation):augmentation rhinoplasty
Day3 (OPD): wound care and change the external splint( thermoplast)
Day3~5 (Tour) :arranging local tour in Taiwan
Day 5~7(Tour): arranging local tour in Taipei after removing partial stitches (columellar stitches) and removing tie-over over ear
Day 7~10(Leave):Leaving after removing the residual stitches. ( intra-nasal stitches and posterior ear stitches.)
And you can keep in communication with doctor by E-mail after going back to your country.
