为什么隆鼻手术七年之后鼻子会突然变薄?

灏や匠 2020-04-11 09:40

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  李永杰 (最佳回答者)

  2020-04-11 11:00
  可以先阅读整形外科杂志所刊载的这一篇报导:

  : Plast Reconstr Surg. 1998 Sep;102(4):1230-7. Related Articles, Links

  Silicone in nasal augmentation rhinoplasty: a decade of clinical experience.

  Deva AK, Merten S, Chang L.

  Department of Plastic and Maxillofacial Surgery at Liverpool Hospital, Sydney, Australia.

  A number of materials, both biologic and alloplastic, have been used for nasal augmentation. Although biologic bone and cartilage grafts are associated with lower infection rates, they are also associated with long-term resorption and donor-site morbidity. Alloplastic materials, in particular silicone, have been associated in the literature with extrusion and infection but have the advantages of being affordable and easy to reshape with no requirement for harvesting autografts. A 10-year experience with silicone nasal augmentation documenting clinical experience, acute and long-term complications, and patient satisfaction was reviewed. All patients undergoing silicone augmentation rhinoplasty between July of 1985 and December of 1995 were reviewed. Preoperative nasal phenotype, operative data, and postoperative outcome were recorded.Long-term follow-up was undertaken using a telephone survey. There were 422 patients who underwent silicone nasal augmentation from July of 1985 to December of 1995. Only nine were men. The indications were for aesthetic nasal augmentation in 98 percent, and the majority (98 percent) were of South East Asian origin. Mean age was 26 (range 17 to 36), and 41 of the 422 patients had had previous nasal augmentation performed before presentation. Twenty-three patients (5.5 percent) had complications requiring removal of the implant within 30 days of surgery. These included displacement, prominence, hemorrhage, and excessive pressure in addition to obvious supratip deformity. On late follow-up, a further 18 patients (4.3 percent) had subsequent removal of the prosthesis. The most common reason for this was either displacement or over-prominence,more often judged by the surgeon than the patient. There were only two patients (0.5 percent) who had extrusion of the prosthesis. A total of 266 patients (63 percent) were contacted for a telephone interview. The majority of patients (84.2 percent) were satisfied with their nasal shape. Of the 42 patients (15.8 percent) who were not satisfied, 21 patients still wanted further augmentation of their nose. Photographic analysis of 198 patients showed a mean augmentation of 16.5 percent (range 4.0 to 27.5). Amount of augmentation correlated with preoperative nasal phenotype. Silicone nasal augmentation is a safe and effective procedure when used for moderate increases in nasal height. Contrary to previous reports, this series showed no associated infection. If the implant is shaped appropriately to the patient's nasal phenotype,the risk of extrusion may be reduced.

  PMID: 9734450 [PubMed - indexed for MEDLINE]

  一般来说,国际文献中,以矽胶隆鼻后感染的机率,从百分之个位数,到28%皆有.国内并没有这方面的统计数字,但是就笔者诊所患者的经验而言,术后发生感染的机率,大该是1%左右.要想避免这种感染的机率,除了医师必须具备绝对的的无菌处理技术之外,医材的选择ˋ术后护理指导,以及患者的自行照顾,皆有关连.

  隆鼻后鼻肉变薄ˋ鼻模穿鼻而出的机率,则相信机率应该是在1%之下,原因是有许多患者,在发现有这个危机后,就尽早的求医而解决了问题.统计上,以人工鼻模隆鼻的患者中,估计再长时间追踪后,应该有少于5%的患者,会须要因为鼻尖肉变薄ˋ鼻模不正等原因,而取出鼻模.
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