Does rhinoplasty with prosthesis produce natural results?

Plastic surgery is prevalent nowadays. Many girls who are not satisfied with their appearance will choose to have plastic surgery. Some girls think that a straight and upturned nose looks better, so they will choose to have a rhinoplasty. The more common methods of rhinoplasty are prosthetic rhinoplasty and autologous cartilage rhinoplasty. The prosthesis generally chosen for prosthetic rhinoplasty is silicone. Silicone has great plasticity and its material is close to human cartilage. It is easy to remove the prosthesis after implantation. However, the effect of prosthetic rhinoplasty is less natural than that of autologous cartilage rhinoplasty.

Artificial Materials

Artificial materials are sometimes a priceless treasure for rhinoplasty surgeons. They can partially replace tissue transplants and are even superior to autologous materials in terms of physical and chemical properties and lasting effects.

1: Expanded polytetrafluoroethylene (ePTFE for short) - Made in the United States, it is currently the best rhinoplasty material in the world; the nose shape after the operation is natural and realistic; but the material is expensive and has high requirements for the surgeon.

2: Solid silicone nasal prosthesis - a commonly used rhinoplasty material by cosmetic plastic surgeons; it has been used as early as 1972. After more than 20 years of observation, although its complication rate can reach 5%-20%, it is still one of the clinically preferred rhinoplasty materials because of its good biocompatibility, good chemical inertness, non-toxicity, non-carcinogenicity, non-teratogenicity, and low price. Solid silicone nasal prosthesis is a solid polymer formed by high-temperature vulcanization. It has a certain elasticity and hardness. There are "L"-shaped and willow-leaf-shaped solid silicone prostheses. The operation is simple and easy, and the price is relatively low. The silicone materials used for rhinoplasty in plastic surgery hospitals are personalized prostheses sculpted by doctors based on the patient's nose shape, and the shape after the operation is natural and realistic.

3: Hyaluronic acid - Hyaluronic acid, also known as hyaluronic acid, is an indispensable component in the skin tissue structure of organisms. As a part of the body tissue, it has good tissue compatibility. Although hyaluronic acid injection rhinoplasty has limitations in its absorption by the human body, it does not require surgery, is quick to take effect, is highly safe, and has a moisturizing function that can increase elasticity, lubrication, and maintain the softness of the skin. The nose shape after hyaluronic acid shaping is naturally straight and straight, without any stiff feeling.

4: Artificial bone materials - mainly refers to hydroxyapatite. It is the main inorganic component of human bone tissue, so it has good biocompatibility, is non-toxic, and has no side effects such as teratogenicity, sensitization, and carcinogenicity.

Advantages and disadvantages of expanded materials

The selection of rhinoplasty materials should be based on the patient's own conditions and economic conditions, combined with the doctor's diagnosis, experience and knowledge.

advantage:

a. Softer than silicone rubber, more natural after surgery.

b. There is no redness of the nose tip after the operation.

c. Tissue can grow into the material, and long-term fixation is better.

d. The nose tip is very soft after surgery. No one can tell that a rhinoplasty was performed unless the patient tells you so.

e. Surgery is also easy to perform on patients with very thin nose skin.

shortcoming:

a. Due to good curing, the material becomes one with the human body and is more difficult to remove than silicone rubber.

Of course, since a one-time surgery can last forever, this problem will only occur when you are not satisfied with the results of the surgery and need another surgery. However, surgeons who have extensive experience with this material generally have mastered special techniques for removal, so there is no need to worry.

b. Higher price than silicone rubber.

c. Sculpture requires rich experience.

d. For adolescents who are in puberty, since all aspects of their body functions are in the development stage, so is the nose. If rhinoplasty is performed at this time, it will easily affect the growth of the nasal bone and nasal cartilage, leading to atrophy of the nose and causing subcutaneous inflammation. You may even have trouble breathing due to swelling in the anus or an upper respiratory infection or allergies.

Aesthetic standards

Rhinoplasty refers to a procedure that improves the appearance of the nose by filling the nose with autologous, foreign tissue or tissue substitutes to raise the external nose. According to experts, the aesthetic standards of rhinoplasty are as follows:

1. Nose length: 1/3 of the facial length, generally 6 to 7.5 cm.

2. Nose width: The distance between the outer edges of the two nostrils is equivalent to 70% of the length of the nose. The width of the root of the nose is about 1 cm, and the width of the tip of the nose is about 1.2 cm.

3. Nose height: The height of the nose bridge at the root of the nose should generally not be less than 9 mm, about 11 mm for women and about 12 mm for men. The height of the nose tip is equivalent to 1/2 of the nose length, which is 26 mm for men and about 23 mm for women.

4. Nasal dorsum line: Generally parallel to the line from the helix to the mandibular body.

5. Nasofacial angle: The angle between the forehead to the incisor line and the forehead to the nasal dorsum line. The ideal angle is 30 to 33 degrees.

6. Nasolabial angle: The angle from the front end of the columella to the base of the nose, and from the base of the nose to the upper lip, is generally 90 to 120 degrees.

7. Frontonasal angle: The angle formed by the nasal bridge and the space between the eyebrows is normally about 120 degrees.

8. Radius of curvature of nose tip: The ideal radius of curvature of nose tip is 8 to 12 mm.

9. Nostril: Oval in shape, with a diameter not exceeding the inner foot of the nose wing.

10. Nose wing width: It is the sum of the lines connecting the upper part of the columella and the two nasal wing edges, which is on the vertical line of the inner canthus.

Advantages of surgery

First of all, the surgical effect of prosthetic rhinoplasty can be predicted, and computer technology can be used to build an accurate and intuitive communication platform between the patients and doctors. Doctors can vividly demonstrate the effects of rhinoplasty to patients in three-dimensional space, and patients can also ask doctors for modification suggestions based on their own aesthetic views, better satisfying patients' desire of "what I want to become".

Secondly, prosthetic rhinoplasty requires surgical experts to fit the features of the prosthesis to the features of the patient. Traditional rhinoplasty requires hand-carving of the prosthesis, but the shape of the patient's nasal bones is not understood. Therefore, the prosthesis produced is difficult to fit the nasal bones completely, which can easily lead to sliding, dislocation, prosthesis deviation, and step-like deformity of the root of the nose. Figure 7 shows the situation after rhinoplasty using the traditional method. It can be seen that there is a large gap between the prosthesis and the nasal bone. The patient reported that the prosthesis floated and swayed under the skin, and the nose looked fake after the surgery. The shape of the digital prosthesis comes directly from the computer-reconstructed nasal bone model. At the same time, the thickness of the prosthesis is accurately calculated by analyzing the difference between the simulation effect and the original nose shape, the deformation of the soft tissue in different rhinoplasty areas, and the digital expert experience library. Therefore, the prosthesis is morphologically consistent with the individual characteristics of the patient, fits firmly, and the surgical effect after implantation is exactly the same as the simulation effect.

Finally, biocompatible materials for prosthetic rhinoplasty. Traditional silicone plastic implants are composed of solid silicone rubber material and chemical additives. Although materials containing chemical additives will not cause major safety hazards after being implanted into the human body, they will have a certain impact on the patient's recovery from trauma. Rhinoplasty is filled with expanded polytetrafluoroethylene shear-arti material, which has good biocompatibility, good aging resistance, resistance to high temperature and high pressure steam sterilization, good stability, combination of biological inertness and biological activity, strong and not easy to break, elastic, and can be adjusted soft and hard at will, easy to process, strong plasticity (easy to shape), white, opaque after implantation, and easy to remove. It has been widely used in soft tissue, hard tissue, plastic implants and other fields.

Material characteristics

1. Silicone: It is the most commonly used rhinoplasty material at present. The operation is simple, the effect is very ideal, the price is low, it has good elasticity, soft touch, easy shaping, good biocompatibility, and rarely causes complications.

2. Expanded polytetrafluoroethylene: From a medical point of view, expanded polytetrafluoroethylene is the most ideal biological tissue substitute. Human tissue cells and blood vessels can grow into its unique microporous structure to form tissue connections, just like autologous tissue. The postoperative effect is more natural and the price is higher than silicone.

3. Autologous cartilage: It has the characteristic of non-rejection of autologous tissue. This method of rhinoplasty is suitable for the overall shaping of the nose and the special shaping of the nose tip. It has the best compatibility with the cartilage at the nose tip and is the most realistic.