Nose Deformity Plastic Surgery

Nose deformity is a congenital defect of the nose or a nasal defect caused by an acquired accident. Nose deformity will not only easily affect breathing, but also greatly affect the appearance. It can be improved through rhinoplasty. Rhinoplasty can correct the nose shape, improve the nose bridge, etc. It can improve nose deformity and also improve the collapse caused by congenital insufficient development of the nose.

Nose Deformity Plastic Surgery

Principle of Shape

First, the treatment of nasal dorsum scar contracture deformity should be carried out by combining the reduction of the stent structure with skin grafting to achieve good therapeutic effects. To repair the wound on the nasal dorsum, use a skin graft or skin flap, depending on the depth of the wound.

Second, the notch-like deformity of the nasal alar defect caused by the linear suture scar on the nasal alar edge can be corrected by Z-plasty. Defects on the nasal alar edge can be repaired by partially flipping it over to form a lining and then transplanting a skin graft onto the nasal alar surface. What is the principle of rhinoplasty? Small full-thickness defects in the nasal wing are best repaired with a free transplant of auricular composite tissue flap. If the defect is large, a local flap such as the nasolabial or forehead flap should be used to repair it.

The third is half nose defect or full nose defect, which is mostly caused by reasons such as etc. The nasal structure is severely damaged. In addition to the defect of nasal skin, it is often accompanied by defects of nasal cartilage or even nasal bone. What is the principle of rhinoplasty? To treat this type of nasal defect, an expander needs to be implanted in the forehead. After about 3 months of water injection and expansion, the forehead flap is used to reconstruct or partially reconstruct the nose. The defective nasal stent is often replaced with rib cartilage. After the nose reconstruction surgery, it is necessary to undergo other operations such as nose pedicle reconstruction and nose trimming, so that a lifelike nose can be created. This is the principle of nose defect plastic surgery.

Repair surgery process

1. Conduct a detailed study of the patient's nasal condition. The defect is located at the nasal dorsum, nose tip, columella, etc. where the skin is relatively thick and the tissue is more special. 2. Make preoperative planning. Nasal surgery should be designed according to the nasal aesthetic unit. If it is less than one unit, it should be enlarged. If it is larger than one unit, it should be reduced to one unit or enlarged to two units.

3. Anesthesia for nasal defect repair. Adults can be anesthetized with local infiltration.

4. Surgical excision to repair nasal defects. The skin around the defect should be trimmed neatly, the scar should be completely removed, the contracture should be fully released, and the displaced tissue should be restored.

5. Repair and stop bleeding of nasal defects. The wound was completely hemostatic.

6. Remove the skin flap. According to the defect area and shape, a slightly enlarged cloth sample is taken, and the skin harvesting range is designed at the cranial angle behind the ear. The skin with fat is removed and trimmed into full-thickness skin grafts for later use. After a slight separation of the subcutaneous tissue on both sides of the donor area, it can be closed in layers.

7. Transplant skin flap. The skin graft is transplanted onto the defective wound of the nose, sutured and pressure bandaged.

8. Repair and bandage of nasal defect. After cleaning the wound behind the ear, bandage the ear with a gauze cotton pad, and cover the nasal skin graft area with gauze.

In addition, after the nasal defect is repaired, everyone needs to take good personal care. The stitches in the donor area should be removed 7 to 10 days after the operation, and the stitches in the grafted area should be removed 10 to 14 days after the operation. Sunlight exposure should be avoided for 3 months after the operation to prevent pigmentation, so as to achieve the best repair effect.

Treatment of deformity

1. Partial defect of nose

Partial nasal defects often occur due to trauma or nasal tumors. Most external injuries are caused by animal bites, especially when the child is young and is bitten by rats, rabbits, pigs and other animals. Therefore, parents should pay attention to the care of infants and young children, because infants and young children have no self-defense ability, their noses and lips are not clean after feeding or eating, and there is residual food odor. The nose also protrudes from the surface, so they are often bitten by animals. The patient had multi-threaded basal cell carcinoma in the elderly and had not received treatment in the early stages, so a full-thickness resection of the nasal wing was necessary when he sought medical attention. If you find that the base of a mole on your face is red, or it breaks open and does not heal, you should seek medical attention early.

If only the tip of the nose or the nose wing is defective, the ideal method is to take a small piece of tissue from the auricle or earlobe for composite tissue free transplantation. If the area does not exceed 1CM2, the success rate is relatively high. The doctor takes a suitable tissue from the ear for transplantation according to the required shape, and the ear is directly sutured, so there will not be too much deformity. This type of surgery requires careful operation and design by the doctor, and you should find a very experienced plastic surgeon. Some people also take a pedicled skin flap from the nasolabial groove to repair defects of the nose wing and nose tip. This is especially true for the elderly and people with loose facial skin. The skin flap can be cut from the nasolabial groove and then transferred. The wound can be sutured directly and the scar is not obvious.

2. Full nose reconstruction

(1) Forehead flap method

The doctor takes a three-leaf skin flap from the center or side of the patient's forehead with a vascular pedicle (pedicle means the root connected to the body that can supply blood and nutrients to the skin flap). Move to the nose, fold the trilobate part into the shape of nose wing, nose tip and columella, and transplant it in the nose. After three weeks, the transplanted nose survives, cut off the pedicle and trim the root of the nose, and a new nose can be created.

The skin on the forehead will be lost after the skin flap is taken, so in the past, skin had to be taken from other parts of the body for transplantation, leaving scars on the forehead from the skin graft and scars on the body from the skin graft. At present, with the invention of skin tissue expanders, doctors use skin expanders to implant in the forehead, and after a period of skin expansion, they perform skin flap transplantation. In this way, the forehead can be sutured directly without the need to remove skin for skin grafting.

(2) Leather tube method

If there is also a defective skin on the forehead that cannot be used, or if you do not want to leave a scar on the forehead, you can roll the skin on the inner upper arm or chest into a skin tube that is connected to the body at both ends and has a columnar middle. After 3 weeks or longer, cut off one end of the tube and implant it on the back of the nose. After another 3 weeks, cut off the other end and use the skin from the tube to shape a nose and implant it in the lower part of the nose. In this way, the nose is created. Since this type of skin is softer than the forehead skin and cannot support the lines of the nose, bone transplantation or medical silicone transplantation is often required as a scaffold to make the nose shape more beautiful.

Corrective surgery preparation

1. Women should avoid menstruation;

2. It is not suitable for people with acute or chronic lesions of the nose skin, such as pustules and inflammation;

3. Stop taking aspirin-type painkillers and all vitamin drugs before surgery;

4. Before the operation, make sure you are in good health and have no infectious diseases or other inflammations in your body. ,

Four major methods

Postoperative care after nasal defect repair

(1) Local flaps are often left behind at the tip of the nose after the removal of tumors such as moles, basal cell carcinomas, squamous cell carcinomas, or bites by animals or people. It is difficult to find local flaps nearby. Only when the surrounding skin is in good condition can a nasolabial groove subcutaneous pedicle island flap be designed to repair the tip defect.

(2) Composite tissue transplantation: For smaller defects in the tip of the nose, earlobe composite tissue transplantation can be used to repair the defect.

(3) Full-thickness skin graft After the tumor or scar at the tip of the nose is removed, the defect can be repaired with a full-thickness skin graft.

(4) Distal flap repair can be performed by using the frontal branch of the superficial temporal artery as a pedicle to form a frontal flap. After 2 weeks, the pedicle is cut off, and the pedicle skin flap is spread out and sutured back to the original skin donor area.