[AetonTV] A Complete Guide to Nose Surgery Materials! (Materials for the Tip of the Nose, Bridge Materials, 3D Implants)

The topic of this post is something

I actually spend quite a long time

discussing during consultations.

It is

a story about materials used in nose surgery.

When surgery is being considered,

which material is good to use,

and what materials are available,

I will clearly answer your questions

about nose surgery materials.

Nose surgery materials can be

divided according to where they are used.

Broadly speaking,

they can be divided into materials used for

the bridge of the nose and materials used for

the tip of the nose.

The reason different materials are used depending on the location is that

each area of the nose has different characteristics.

When the nose is divided into three parts,

the upper and middle parts are hard

and do not move.

On the other hand, the lowest part, the tip of the nose,

can be pressed inward and

can move like a pig’s nose.

So the roles of the materials needed for the bridge and the tip are also different.

For the bridge, which does not move,

the important role is mainly to add volume,

so a material with fullness is needed.

Conversely,

the tip of the nose needs a structural support

that can maintain the shape of the nose.

Bridge: volume

Tip: structure!

First,

let’s look at the materials used for the bridge of the nose.

Materials that add volume to the bridge include

artificial materials and autologous tissue materials.

Among artificial materials,

silicone and Gore-Tex are the most common.

In particular, silicone is used overwhelmingly often.

Autologous tissue materials include

dermis, fat, and costal cartilage (rib cartilage).

Dermis or fat is harvested from the buttock area and used,

or rib cartilage is carved into pieces and used.

There is also a material that is neither

autologous tissue nor artificial.

It is an implant made using another person’s skin tissue.

It is a material worth considering for people who feel burdened by completely artificial materials

or for those who have disadvantages when harvesting autologous tissue.

Next,

let’s look at the materials for the tip of the nose,

where structural support is important.

Tip materials can be divided into

autologous tissue and biologically derived tissue.

For cartilage that provides the nose tip structure,

autologous cartilage is mainly used.

The most representative type of autologous cartilage

is septal cartilage.

The septum is

the cartilage inside the wall between the nostrils,

and since it can be harvested during nose surgery,

it is a very advantageous material.

If the size is sufficient,

I think it is one of the most ideal materials.

And

there is also ear cartilage,

which many of you may be more familiar with.

It is harvested from the ear,

and the inner cartilage is used so that

the shape of the outer ear does not change.

If harvested well,

it looks so natural that no one can tell where it was taken from.

And costal cartilage, which has been getting a lot of attention lately,

can be thought of as a substitute for septal cartilage.

In surgical methods such as septal extension grafting,

the material itself is sometimes changed to costal cartilage.

Because costal cartilage is large and strong,

it can be said to be the most structurally stable cartilage.

However,

it cannot be harvested during nose surgery,

and there is the burden of creating a separate harvest site.

In addition to autologous costal cartilage,

there is also donor costal cartilage.

It is a product made by safely processing another person’s cartilage

and supplying it in product form,

and because it has no cells,

it comes in as cartilage itself that has been processed so that

the body does not attack it.

Compared with autologous cartilage,

in an ideal environment,

the difference between autologous cartilage and donor cartilage may be almost negligible.

However,

in stressful situations such as inflammation,

using living autologous cartilage is generally somewhat more advantageous.

So with so many different materials,

how is the choice of material decided?

It is determined by comprehensively considering each person’s nose condition,

desired shape, and previous surgery history.

In particular, for the bridge of the nose,

if appearance alone is considered,

silicone is superior,

but if the skin is thin or there has been a history of silicone side effects,

autologous materials are recommended.

When selecting materials for the tip of the nose,

using autologous materials is the best option.

For a first surgery,

septal cartilage or ear cartilage is considered first.

When choosing between septal cartilage and ear cartilage,

the decision depends on the desired nose shape.

If you want a sharp nose,

septal cartilage is advantageous,

and if volume supplementation is needed,

ear cartilage is often more advantageous.

The size of the two cartilages is also an important variable.

If the septal cartilage is too small,

it is difficult to determine the exact size with the naked eye,

so it is assessed with a CT scan

and a plan is made for the case where it is insufficient.

For example,

one may consider supplementing the septum with ear cartilage,

or using donor costal cartilage

or autologous costal cartilage instead of the septum.

In cases where a greater increase is desired for revision surgery,

especially if the previous surgery used the septum,

surgery using costal cartilage is often safer.

If there is no history of inflammation,

there is not a major difference between autologous costal cartilage and donor costal cartilage,

but if there is a history of inflammation or contracture,

autologous costal cartilage is better.

Finally,

these days there is also a lot of interest in 3D-printed implants.

You can think of a 3D-printed implant like a custom-tailored suit.

It is made to fit the patient’s nose shape exactly.

However, this does not apply to every situation,

and it is advantageous in special cases where the nose shape is difficult to achieve with a standard implant.

For example,

if the brow bone is severely protruding and the curvature is pronounced,

or if there is severe asymmetry in the nasal bone or cartilage,

a 3D implant fits well

and also helps with postoperative recovery and complication prevention.

Because of the manufacturing method,

the properties of the silicone itself are slightly different from those of standard implants.

Personally,

I think the properties of standard implants are better,

and most nose shapes can still be matched well enough

with standard implants.

In this post,

we looked into questions about materials used in nose surgery.

I hope this was helpful for those of you

who are considering nose surgery.

Thank you.