Augmentation Rhinoplasty Research Articles

Reconstruction of Nasal Tip Using "Seagull-shaped" Cavum Concha Cartilage Composite Scaffold.

The nasal tip plays a crucial role both esthetically and functionally. The application of nasal tip grafts is an effective method for improving nasal tip form. Ear cartilage is a common choice for nasal tip grafts, but it still presents several challenges in clinical application that need to be addressed. This study aims to address the issues associated with the use of ear cartilage in clinical rhinoplasty applications through the development of a novel septal extension graft using ear cartilage for nasal tip reconstruction. From May 2018 to April 2022, a total of 132 cases of nasal tip reconstruction surgeries were performed using a seagull-shaped nasal septum extension graft, constructed with bilateral cavum concha cartilage. Among these cases, 25 patients had previously undergone rhinoplasty using silicone implant, 7 patients had undergone augmentation rhinoplasty using expanded polytetrafluoroethylene, whereas the rest were primary rhinoplasty cases. All patients were followed up for a period ranging from 3 months to 4 years postoperatively, with photographs taken to assess the nasal tip morphology. In this study, all patients exhibited good healing of the incisions made at the posterior aspect of the auricular concha, with no occurrences of hematoma and inconspicuous scarring. In 116 cases, significant improvement in nasal appearance and a realistic nasal tip form were achieved postoperatively, yielding satisfactory outcomes. Only 16 patients experienced minor issues with nasal tip morphology, which were subsequently improved through further surgical procedures. This study reports a surgical technique for nasal tip refinement using bilaterally harvested cavum concha cartilage to construct a seagull-shaped nasal septal extension graft. The procedure has achieved satisfactory outcomes, and its application is worth extending to clinical practice.

A modified technique for autologous dorsal nasal augmentation rhinoplasty.

Autologous dorsal cartilage grafts are usually the first choice for nasal augmentation. We aimed to describe a modified technique for autologous dorsal nasal augmentation rhinoplasty. The study group consisted of a retrospective review of patients who underwent augmentation rhinoplasty surgery and were treated with diced cartilage in platelet-rich plasma (PRP) in the last five years at King Abdulaziz University Hospital. Gender, age, smoking history, saddle nose etiology, complications, mean duration of surgery, mean duration of hospital stay, morbidity, mortality, and surgical technique used were assessed and analyzed. The outcome of this technique was compared with other techniques used for augmentation rhinoplasty published in the current literature. A selective, retrospective analysis was conducted on patients undergoing rhinoplasty between 2017 and 2022. A total number of 30 patients' files were reviewed; of those, eight patients were males, and 22 were females. The average age of the participants was 33, with a minimum of 19 years and a maximum of 55. The indications for surgery are listed in Table II. Cartilage graft was harvested from the concha in 14 patients, from the septum in eight patients, and from both sites in eight. Male and female samples are shown in Figures 1 and 2. We have only observed graft resorption in two female cases, and none of the patients had any complications. We have assessed the patients who underwent rhinoplasty with the modified technique for autologous dorsal augmentation. The combination of diced cartilage and PRP yielded good results with a low resorption incidence; when done correctly, no complications were observed. Platelet-rich plasma (PRP) contains a greater volume of platelets and Platelet-Derived Growth Factors, which exert multiple actions on different aspects of reparative and regenerative tissue phenomena. Augmentation rhinoplasty using PRP offers stabilization and enclosure of diced cartilage without the risks of hypersensitivity or disease transmission.

Outcomes of Diced Cartilage Dorsal Augmentation in Dorsal Aesthetic Deformities.

Objective: To investigate the effectiveness of diced cartilage graft for dorsal augmentation in rhinoplasty. Methods: In a retrospective study, patients who underwent rhinoplasty with dorsal augmentation using diced cartilage graft from June 2017 to December 2021 were identified. Patients with complete preoperative and at least one postoperative Standardized Cosmesis and Health Nasal Outcomes Survey-Cosmesis (SCHNOS-C) and visual analogue scale (VAS) scores were included in the study. Postoperative periods were classified into ≤6 and >6 months. Mean preoperative outcome scores were compared with postoperative scores utilizing a Paired t-test, and postoperative scores were compared utilizing a Wilcoxon rank-sum test. Results: A total of 71 patients with a median age of 36 years, range (18-74) fit inclusion criteria. Majority were female patients 49 (69%). The postoperative period ranged from 17 days to 3.5 years. The mean follow-up period (standard deviation) for ≤6 and >6 months was 2.8 (1.5) and 14.2 (6.3) months, respectively. A decrease in mean SCHNOS-C, SCHNOS item 8, and an increase in VAS scores (p < 0.0001) were seen at both postoperative time periods compared with preoperative levels. Conclusion: This study demonstrates that dorsal augmentation with diced cartilage graft is an effective technique in correcting dorsal aesthetic deformities.

Complications Associated with Alloplastic Materials in Rhinoplasty and Their Operative Management.

Whereas rhinoplasty with a reduction of the dorsum and modification of the tip is a common procedure among Caucasians, augmentation of the dorsum remains a challenge in Asians. Choice of the ideal grafting material for dorsal augmentation is a matter of preference and remains under discussion. Autologous and alloplastic materials have their advantages and disadvantages. We report our experiences of the extrusion of alloplastic materials and their management. We report of 18 patients, who had rhinoplasty in the past for dorsal augmentation with alloplastic material. Augmentation rhinoplasty was performed in Asia (n = 15) and Germany (n = 3). All cases showed recurrent signs of foreign body infection and/or partial extrusion and therefore underwent revision surgery in our centers. Once all patients had been successfully treated with antibiotics, we performed a one-stage revision rhinoplasty with explantation of the alloplastic material and subsequent reconstruction with autologous rib cartilage. The nasal dorsum was augmented with either solid rib cartilage grafts, diced cartilage in fascia, or free diced cartilage in platelet-rich fibrin. All patients received pre-, peri-, and postoperative antibiotics. The outcome was screened via clinical examination, ultrasound examination pre- and postoperatively, two-dimensional/three-dimensional (3D) imaging, and magnetic resonance imaging scans.Alloplastic augmentation of the nasal dorsum runs the risk of foreign body reaction, recurrent infections, uncontrolled scarring, and unsatisfying long-term results. We have obtained a series of aesthetically and functionally satisfying results after single-stage revision surgery with autologous cartilage and demonstrate a variety of novel postoperative screening tools including 3D imaging and high-frequency ultrasound. LEVEL OF EVIDENCE: N/A.

Le Fort I and nasal fracture, primary reduction, and secondary revision saddle nose: A case report

Maxillofacial trauma is a common clinical situation in emergency rooms. Lesions involving the maxillofacial complex pose a significant public health challenge, not only due to their costs but also because of the potential functional and aesthetic issues that patients may experience. While some fractures are more suitable for delayed treatment, others necessitate immediate attention, requiring intervention within 24 hours of the trauma occurrence. Different types of reduction and fixation exist depending on the patient’s age, location, type of fracture, and the surgeon’s preferences. We reported a case of a 20-year-old female patient diagnosed with Le Fort I bilateral fracture and closed nasal fracture followed by saddle nose. The patient was managed with open reduction internal fixation and closed reduction nasal bone. The saddle nose in the patient was managed four months later by augmentation rhinoplasty with rib cartilage and pearl fat graft. Proper management of Le Fort I fracture and nasal fracture accompanied with saddle nose by open reduction internal fixation and augmentation rhinoplasty with rib cartilage and pearl fat graft can restore occlusion and improve symmetrical, proportional facial aesthetics, which is the indicators of a successful holistic maxillofacial trauma management.

Use of hyaluronic acid matrix in dorsal augmentation rhinoplasty

ABSTRACT Augmentation rhinoplasty sometimes is required for patients with saddle nose deformity caused by failed rhinoplasty or facial trauma; finding appropriate grafting material remains a significant problem for this procedure. We investigated hyaluronic acid matrix as an allograft for dorsal augmentation rhinoplasty in a rabbit model. We performed an osteotomy on the nasal bones of eight rabbits. Four animals were sham operated as the control group and four were administered a mixture of saline-gelled hyaluronic acid matrix and sliced cartilage. Ultrasonography and three-dimensional reconstruction tomography were performed at the end of the experimental period. After sacrifice of the animals, nasal tissues were examined for histopathology, and both collagen scores and number of capillaries were compared between the two groups. Increased collagen and capillaries were apparent in the hyaluronic acid matrix group compared to controls. The median collagen score was significantly greater for the hyaluronic acid matrix group than for the control group. Although the number of capillaries for the hyaluronic acid matrix group was greater than for the control group, the difference was not statistically significant. Three weeks is sufficient for adhesion of ends of fractures in clinical practice; however, we found no ossification at this time in either group. A hyaluronic acid matrix may be a useful alternative supplement for dorsal augmentation rhinoplasty. Development of collagen was commensurate with membranous ossification; however, assessment of complete ossification requires a longer experimental period.

Success and Complication Rates of Different Techniques and Materials Used for Nasal Dorsal Augmentation in Rhinoplasty

Abstract Background Autologous materials, homograft and alloplastic implants are commonly used in nasal dorsal augmentation. So far, there is no satisfactory evidence to ascertain the safest, efficient, and superior in aesthetic outcomes among different materials. Thus, we aimed to conduct a systematic review and metaanalysis (SR, MA) of published literature to review rates of outcomes and complications of different materials used for nasal dorsal augmentation, in trial for better future surgical results. Methods Thirteen electronic databases were searched from inception through December 2018 and a manual search in October 2019. Results A total of 280 eligible studies were included, of which 165 articles were included in the meta-analysis. Compared to others, alloplastic expanded polytetrafluoroethylene (alloplastic e-PTFE) was considered first place, for having the highest graft scores in most of its outcomes; secondary deformity, resorption, patients’ satisfaction, displacement, extrusion, seroma, graft deviation, swelling, and hematoma outcomes with rates of (2%, 0.6%, 96.5%, 1.3%, 1.2%, 1%, 1%, 0.8%, 0.8%)respectively. Alloplastic silicone came after e-PTFE, for its superior results in revision rhinoplasty, success rate, aesthetic function, and scarring outcomes (4.1%, 99.9%, 98.8%, 2.7%) respectively. Autologous bone graft came at the last place as it had the least graft scores in patients’ satisfaction, displacement, perforation, and hematoma outcomes (50.7%, 9.3%, 8.3%, 5.4%)respectively. Autologous diced cartilage was superior in those outcomes; edema, bruising, and donor site complications (7.1%, 7.4%, 4.4%) respectively. Autologous costal cartilage had the highest graft scores in necrosis and graft exposure outcomes (4.3% and 1.9%), while it had the lowest graft scores in warping and success rate (7.1% and 87.3%). Autologous auricular cartilage had the highest graft scores in warping and foreign body reaction outcomes (1.4% and 6.3%), while it had the lowest graft scores in nasal obstruction and donor site complications rate (72.7% and 33.3%). Infection was the most common reported complication in MA, where autologous alar cartilage had the lowest infection rate of 0.2%, unlike alloplastic Medpor recorded the highest risk of 6.6%. Conclusions Regarding our results, we concluded that alloplastic e-PTFE yielded superior position in comparison to other materials, that would succeed as an alternative to convential autologous grafts, as had superior results in most of nasal dorsal augmentation outcomes. On the other hand, autologous bone graft was in the last place in all its outcomes. Future studies are needed to improve reporting of races variety, follow-up times, and diverse participants, as to resolve uncertainty regarding the ideal material for dorsal augmentation in rhinoplasty, with concentrating on proper assessment of races variety, which will improve selecting the proper graft implant.

Safety and Efficacy of Autologous Cartilage Graft in Augmentation Rhinoplasty.

Augmentation rhinoplasty or commonly known as "nose jobs" is one of the most common plastic surgical procedures aimed to improve cosmetic appearance. This procedure is considerably safer, less time consuming with faster recovery and immediate cosmetic effect. This procedure needs of highly experienced and well-trained plastic surgeon. According to facial analysis you can select the type of rhinoplasty. Open discussion with the patient to select appropriate surgical technique and its possible risks with your plastic surgeon to ensure the highest level of safety and satisfaction. Autologous grafting materials are safe, efficient and also the first choice for rhinoplasty due to it can survive without a vascular supply, the resorption rate of cartilage is much lower than that of a bone graft. Autologous grafting materials are stable and resistant to infection and extrusion over time so, they are successfully used for dorsal augmentation. To perform successful augmentation rhinoplasty, surgeons should be highly experienced and well-trained and augmentation materials that are currently available and understand their risks, benefits and uses. Autologous cartilage graft regarded as the graft of choice in augmentation rhinoplasty because of their lower rate of infection, rejection, resorption, extrusion, donor site morbidity, easy reshaping.

Scar folding for the treatment of nostril stenosis after open rhinoplasty: a case report

A 25-year-old woman was referred for discomfort when breathing through her left nose. The patient had undergone augmentation rhinoplasty 5 years ago, after which hypertrophic scarring occurred in the left nostril. Several corticosteroid injections were administered as the first line of treatment, but with no symptom improvement. Therefore, we proceeded with surgical scar removal, with the use of a nasal conformer. However, scarring in the left nostril recurred. Accordingly, we proceeded with further surgical treatment using the scar folding technique. After scar folding, neither scarring nor nostril stenosis recurred during 1 year of postoperative follow-up. To summarize, herein, we report a case of hypertrophic scarring in the nostril that was successfully treated with the scar folding technique.

A reinforced framework construction technique using unilateral auricular cartilage in Asian rhinoplasty to prevent long-term nasal tip drooping

Enhancing nasal tip projection is an important objective in Asian rhinoplasty. Nasal tip enhancement using auricular cartilage is simple and suitable for Asian patients. However, the long-term retraction problem of the auricular framework still needs to be solved for optimal results. The authors propose a modified auricular cartilage framework construction technique that provides stronger long-term support to the nasal tip and columellar base. Eighty-one patients underwent augmentation rhinoplasty between January 2016 and December 2019. The cymba and cavum conchae were harvested from one ear in all cases. The cymba concha was carved and folded to form a caudal septal extension graft (CSEG). The cavum concha was divided into an integrated cap/shield graft and a columella base graft. The columella base graft was diced into particles in size of 1mm3, and inserted into the gap between CSEG, anterior nasal spine, and the medial crus to strengthen the foundation. The nasal profile was analyzed before the operation and at least 12 months after the operation. The patient satisfaction score was assessed 12 months after surgery. Patients were followed up for 12-36 months. The nasal tip projection from both the lateral and basal views was significantly improved. The columella-labial angle was increased from 83.15° (6.20°) to 96.50° (7.40°) (p<0.05). The nostril tip proportion increased from 0.83 (0.14) to 1.17(0.16) (p<0.01). A stable long-term outcome was achieved. With the modified framework construction technique, long-term nasal tip drooping can be prevented. This method can be a practical choice for Asian patients seeking augmentation rhinoplasty.

Prevention and Resolution of Silicone Implant-Related Problems in Secondary Rhinoplasty Using a Cross-Linked Human Acellular Dermal Matrix.

Silicone implant augmentation rhinoplasty along with various tip plasties are commonly performed in Asian patients, but a revision rhinoplasty is frequently required because of various problems. Secondary rhinoplasties are often performed using silicone, dermofat, costal cartilage block, or diced rib cartilage, but often result in unsatisfactory outcomes. This study assessed the surgical outcomes and complications of cross-linked acellular dermal matrix (ADM) as an alternative biological substitute for silicone implant in secondary rhinoplasty. The authors prospectively studied 56 patients with a minimum follow-up of 1 year among 104 patients who underwent secondary rhinoplasty in their clinic between January of 2015 and December of 2018. Silicone implant, capsule, and scar tissue removal; dorsal augmentation with ADM; and tip plasty using autogenous cartilage were performed for all of them. The results were assessed using the modified Rhinoplasty Outcome Evaluation, consisting of a 10-item questionnaire completed preoperatively, 6 months postoperatively, and over 1 year postoperatively. One infection and three cases of excessive resorption were noted, with no other major complications. The mean modified Rhinoplasty Outcome Evaluation score was 31.7 on preoperative evaluation, 77.3 at 6 months postoperatively, and 81.4 at 1 year postoperatively (mean difference, 45.6 and 49.7, respectively; P < 0.001). Various problems that occur after primary rhinoplasty using silicone implants can be resolved successfully with secondary rhinoplasty by dorsal augmentation using the cross-linked human ADM along with various nasal tip work using autogenous cartilage. Surgical outcome showed favorable resolution of contracture deformities, a low infection rate, firm fixation of the implant, good skin texture/thickness of the skin/soft-tissue envelope, and gain of desired height and dorsal line. Therapeutic, IV.

Preoperative computer imaging before augmentation rhinoplasty.

In the present study, we investigated the efficacy of morphing technology via Adobe PhotoShop program and its "liquefy" effect in patients planned to undergo augmentation rhinoplasty. The retrospective data for 100 consecutive augmentation rhinoplasty cases (64 females and 36 males) were enrolled in our study. Preoperative computer imaging (PCI) steps, a stepwise systematic guide for image editing, including (1) augmenting the dorsum, (2) lengthening the nose, (3) adjusting the tip projection, (4) perfection of the nasal dorsum and (5) exaggerating the tip projection and/or the dorsal augmentation were applied to the patients. After performing the PCI before augmentation rhinoplasty, the patients were allowed to see the options for the final appearance of their noses. Therefore, PCI helped them to decide on their operations. After applying CS-PCI before augmentation rhinoplasty, 71 patients (71%) accepted Step-4, and 19 (19%) accepted Step-3. Furthermore, six patients (6%) requested additional changes during their operational planning. In 95% of the cases, the authors achieved the results agreed upon based on the preoperative simulation. By PCI involving five steps for augmentation rhinoplasty, the patients were allowed to see the options for the final appearance of their noses. Therefore, PCI helped them to decide on their operations. With the help of morphing technology (2D), it is possible to increase interpersonal communication effectively.

Lessons Learned From Using Silicone Implants in Clean-Contaminated Regions of the Face.

Augmentation rhinoplasty changes the shape of the nose using implanted material. In the 1980s, nasal implantology began to favor silicone over traditional autologous grafts because the synthetic material presented exciting benefits. However, long-term complications of nasal silicone implants have since emerged. This has necessitated the introduction of safe and effective materials. Despite an overwhelming transition to the use of improved implants, craniofacial surgeons will likely continue to see the consequences of silicone implant use as long-term complications arise in the innumerable patients who have had this procedure worldwide.

Application of Auricular Cartilage Scaffold Combined With L-Shaped Prosthesis in Asian Rhinoplasty.

Rhinoplasty is a common surgical procedure in medical cosmetology. From patients with saddle nose deformity to beauty seekers with low and short noses, this surgery is mainly sought to improve the nose's appearance. To investigate the effect of modified auricular cartilage scaffold combined with L-shaped prosthesis in rhinoplasty. This retrospective study included 54 patients who underwent auricular cartilage augmentation rhinoplasty with L-shaped implants in our hospital from July 2018 to July 2021. The function of nasal ventilation and olfaction was inspected. As a result, the degree of nasal tip protrusion and the changes in the superior lip angle of columella were improved. The patients' satisfaction was measured a year after the surgery. Patients who underwent auricular cartilage augmentation rhinoplasty with L-shaped prosthesis were satisfied with the surgery outcomes. Using a protective auricular cartilage scaffold combined with an L-shaped implant for augmentation rhinoplasty reduced the shortage of the application and reinforced the stability of the auricular cartilage augmentation rhinoplasty. At >12 months follow-up, there were no serious adverse effects on nasal ventilation and olfactory function in any of the patients. The presented method made full use of auricular cartilage so that it reduced the harvest of the cartilage. Besides, it achieved the remarkable lift of the nose tip, thus simulating the appearance of costal cartilage rhinoplasty. Furthermore, the risk of implant exposure was efficiently reduced, making it worthy of clinical application.

Injectable Cartilage Microtissue Regenerated by Autologous Chondrocytes for Nasal Augmentation: A 5-Year Follow-Up Study.

A lack of ideal filling materials is a critical limitation in current rhinoplasty. Cartilage sheet regeneration by autologous chondrocytes is expected to provide an ideal source of material. However, the inability to perform minimally invasive transplantation of cartilage sheets has greatly limited the clinical application of this material. In this article, the authors propose the concept of injectable cartilage microtissue (ICM) based on cartilage sheet technology, with the aim of achieving minimally invasive augmentation rhinoplasty in clinical practice. Approximately 1.0 cm2 of posterior auricular cartilage was collected from 28 patients. Isolated chondrocytes were expanded, then used to construct autologous cartilage sheets by high-density seeding and in vitro culture in chondrogenic medium with cytokines (eg, transforming growth factor beta-1 and insulin-like growth factor-1) for 3 weeks. Next, ICM was prepared by granulation of the cartilage sheets; it was then injected into a subcutaneous pocket for rhinoplasty. ICM was successfully prepared in all patients, and its implantation efficiently raised the nasal dorsum. Magnetic resonance imaging confirmed that regenerative tissue was present at the injection site; histologic examinations demonstrated mature cartilage formation with typical cartilage lacunae and abundant cartilage-specific deposition of extracellular matrix. Excellent or good postoperative patient satisfaction results were achieved in 83.3% of patients over 5 years of follow-up. Obvious absorption of grafts occurred in only two patients (8.3%). These results demonstrated that ICM could facilitate stable cartilage regeneration and long-term maintenance in the human body; the implantation of ICM enabled natural augmentation of the depressed nasal dorsum. Therapeutic, IV.

Hybrid Autologous Costal Cartilage Grafting for Augmentation Rhinoplasty in Asian Patients.

Autologous costal cartilage has been used for augmentation rhinoplasty in Asia for many years. This study aimed to assess the effectiveness and safety of hybrid grafting of costal cartilage for dorsal augmentation, septal reconstruction, and tip augmentation for Asian patients. A surgical technique was introduced and patients having rhinoplasty using this technique from April 2020 to March 2021 were retrospectively studied. In this technique, costal cartilage was meticulously carved or diced and grafted in various ways mainly based on the anatomic characteristics of nasal skin and subcutaneous soft tissues as well as bone and cartilage framework. The surgical outcomes, patient satisfaction, and complications retrieved from the documented medical records were reviewed and analyzed. Twenty-five patients having rhinoplasty with the proposed technique were followed up from 6 months to 12 months. As for cosmetic outcomes, 21 patients were graded as good, 3 patients were graded as fair, and only 1 patient was graded as poor. Those patients who were not graded as good had over-rotated tips, insufficient dorsal augmentation, or asymmetry of nostrils and soft tissue contracture. The overall patient satisfaction was as high as 96.0%. Local infection occurred in 1 patient and hematoma was not observed. Warping and visibility of costal cartilage were not observed in any patients. Slight displacement of diced cartilages was found in 2 patients near the radix 1 week postoperatively. Hybrid autologous costal cartilage grafts can be used for both tip refinement and dorsal augmentation for East Asian patients and achieve an outcome of a natural-looking nose with minimal complications. Level IV.

Customized Augmentation Rhinoplasty With Morpheus 3-Dimensional Scanner.

Three-dimensional (3D) scanning-based morphologic analyses of facial structures are becoming more popular in several clinical settings. However, the application has not yet been reported in augmentation rhinoplasty. The purpose of the study is to show the efficacy of the Morpheus 3D scanner for preoperative planning in rhinoplasty. In this retrospective review, 241 patients who underwent primary and secondary rhinoplasty from September 2018 to August 2020 were reviewed. The authors determined the degree of augmentation preoperatively using the Morpheus 3D scanner based on patients' esthetic needs. According to the simulated 3D embodiment result, the Silicone implant was carved and implanted with closed or open rhinoplasty approach. The operation was performed based on the simulated 3D shape, and the patients were satisfied with the esthetic outcomes. Morpheus 3D scanner can be a valuable tool for esthetic rhinoplasty planning. This tool also provides preoperative customized patient counseling based on their current anatomic characteristics and esthetic needs.

Design and Application of a Novel Silicone Nasal Implant.

Traditional silicone implants used in augmentation rhinoplasty lead to postoperative complications. To introduce a novel silicone implant designed to reduce postoperative complications. The author designed a novel modification for the traditional silicone nasal implant, which has a particle surface, vertical and horizontal grooves, and a special vertical board to support the nasal tip. A total of 114 consecutive clinical cases were retrospectively reviewed from September 2016 to November 2022, with a minimum of 36 months and an average 51 months of follow-up. All patients underwent augmentation rhinoplasty using this novel implant, with 97 (85.09%) patients using only the silicone and 17 (14.91%) the silicone implant with conchal cartilage. Surgical complications such as sliding down, redness, extrusion, deviation, translucency, capsular contracture, or infection were recorded. The median patient age was 28 (range, 18-55) years, with 109 female and 5 male patients. Among the 114 cases, 46 (40.35%) involved primary surgery and 68 (59.65%) involved revisional surgery. The overall complication rate was 4.39%, and 0.88% of the patients had slight redness, 0.88% had intermittent pain, and 2.63% had infections. No other complication was observed, and all complications occurred in revisional surgeries. A total of 109 patients (95.61%) showed satisfying results without any postoperative complication. None of the patients with primary surgery reported postoperative complications. The novel silicone nasal implant can effectively reduce the rate of postoperative complications. Therefore, augmentation rhinoplasty using this implant enables a more natural-looking outcome.

Combining Diced Cartilage with Chondrocyte Spheroids in GelMA Hydrogel: An Animal Study in Diced Cartilage Grafting Technique.

The phenotype maintenance of diced cartilage is a very important factor to reduce cartilage absorption rate in augmentation rhinoplasty. A novel method which combined diced cartilage with chondrocyte spheroids in gelatin methacrylate (GelMA) hydrogel may have potentially good performance in phenotype maintenance, and is worth exploring. The complex grafts formed by loading diced cartilage with chondrocyte spheroids into GelMA hydrogel were used as the experimental group, and the grafts formed of diced cartilage in GelMA were used as the control group. The two groups of grafts were implanted subcutaneously in nude mice. After 1 month and 3 months, the grafts were taken for general observation and histological analysis. The diameter changes of cartilage, the nuclei loss of chondrocyte, and glycosaminoglycan secretion were analyzed. Chondrocyte spheroids with obvious proliferation can be seen in the experimental group. Some diced cartilages had become a whole through the interconnection of chondrocyte spheroids. In addition, the diameter of the chondrocyte spheroids-diced cartilage complex in the experimental group increased significantly, and its nuclei loss rate was less than 1/2 of that in the control group. The maintenance of proteoglycans in diced cartilages in the experimental group was significantly better than that in the control group. The combination of diced cartilage with chondrocyte spheroids in GelMA hydrogel can significantly reduce the absorption of cartilage extracellular matrix, enhance phenotype maintenance during subcutaneous ectopic implantation, and can produce inter-chondral connections.

Analysis of the Effect of Autogenous Costal Cartilage Transplantation Combined with Silicone Augmentation Rhinoplasty in Nasal Cosmetic and Plastic Repair

Purpose: To analyze the application value of autogenous costal cartilage transplantation combined with silicone augmentation rhinoplasty. Methods: From January 2022 to January 2023, 84 patients with cosmetic and plastic repair of nose were divided into observation group (44 cases were treated with autogenous costal cartilage transplantation combined with silicone augmentation rhinoplasty) and control group (40 cases were treated with silicone augmentation rhinoplasty) according to the surgical intention of the patients. Compare the difference of prognosis indexes between the two groups after operation, and compare the changes of nasal parameters before and after operation between the two groups, and finally compare the difference of patients' satisfaction between the two groups. Results: ①The 3dVAS score of the observation group was lower than that of the control group (P<0.05), and the wound healing time was shorter than that of the control group (P<0.05); ②The incidence of postoperative complications in the observation group was 4.5%, and that in the control group was 15%. The incidence of postoperative complications in the observation group was lower than that in the control group (P＜0.05); ③There was no significant difference between the two groups (P>0.05) in the angle of nose, the height of nose root and the angle of nose face before operation. The angle of nose tip, the height of nose root and the angle of nose face in the observation group were higher than those in the control group 3 months after operation (P<0.05); ④The satisfaction of the observation group was higher than that of the control group (P<0.05). Conclusion: Autogenous costal cartilage transplantation combined with silicone augmentation rhinoplasty has the advantages of short wound healing time, less postoperative complications and good repair effect, which is helpful to improve the satisfaction of patients and can be widely used.