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Rhinoplasty

Recently, the trend in rhinoplasty has been

continuously demanding solutions that properly reflect the patient's needs,

minimally invasive,

natural,

and free of side effects.

At our clinic,

we perform surgeries that are natural and free of side effects

using silicone, Alloderm, and microfat grafting.

Director Shin Duhan

What are the indications for rhinoplasty?

▶ When the nasal bridge is low

▶ When there is a contour or visible deviation along the bridge of the nose

▶ Hump nose with a crooked tip

▶ Saddle nose with a collapsed bridge

▶ When nasal deformity occurs due to an accident

▶ Functional obstruction that causes difficulty breathing through the nose

▶ Boxy nose that makes the nostrils look wide

What is the anatomy of the nose?

The basic structure of the nose consists of the nasal bone and nasal cartilage forming the framework, with soft tissues such as muscle and skin covering it.

The most important structure determining the shape of the nose tip is the alar cartilage, and the shape of the nasal bridge is determined by the nasal bone.

What are the methods of rhinoplasty?

What is the silicone method?

It is the most widely used and safe method for augmenting the nasal bridge.

It has the advantages of being easy to shape the implant, maintaining the designed shape well after insertion, having almost no side effects, and being easy to remove if the patient wants the implant taken out.

Silicone is the implant material most widely used by board-certified plastic surgeons around the world, having been recognized for its safety and effectiveness over decades.

Disadvantages of silicone

There are no disadvantages compared with any surgical method to date.

Advantages of silicone

It does not easily cause inflammation.
It is easy to design into the desired shape.
Even after decades, the shape rarely sinks or becomes deformed.
If side effects occur, removal is simple.
The surgical cost is lower than other methods.

What is the Gore-Tex method?

It is a softer material than silicone and was used to compensate for silicone's shortcomings, but many side effects such as inflammation have been reported to this day.

Its disadvantages are that it is not easy to create the desired shape, the Gore-Tex can change shape or become distorted after insertion into the nose, and side effects such as inflammation occur frequently, often requiring removal again.

There is also the problem that if you want to remove it because you do not like the shape, removal is very difficult.

It is not a good material for use as a rhinoplasty implant.

Disadvantages of Gore-Tex

Inflammation occurs frequently.
It is difficult to design into the desired shape.
After several years, the shape may sink or become deformed.
If side effects occur, it is very difficult to remove.
The cost is higher than silicone.

What is the method using septal cartilage?

This is cartilage harvested from the nasal septum inside the nose and is mainly used to raise the columella or elevate the nose tip.

It cannot be used to raise the nasal bridge like silicone.

It is used when the bridge is too flat and you want to slightly raise the tip like an upturned nose.

Disadvantages of septal cartilage

It cannot be used to raise the nasal bridge.
Because the cartilage is very thin, effective augmentation is often difficult.
If you do not like the shape, it is difficult to remove.
The surgery takes a long time and is expensive. The surgery takes a long time and is expensive.

What is the method using ear cartilage?

It involves harvesting conchal cartilage from the auricle and is mainly used for nose tip surgery, like septal cartilage.

Its disadvantages are that the cartilage is curved and irregular in shape, making it difficult to shape; the ear from which the cartilage is harvested may be deformed; and if the shape becomes distorted after grafting or if you do not like it, removal is very difficult.

It is mainly used when you want to slightly raise the nose tip.

Disadvantages of ear cartilage

It cannot be used to raise the nasal bridge.
Because ear cartilage must be removed, scars and deformity may occur in the ear.
If you do not like the shape, it is difficult to remove.
The surgery takes a long time and is expensive.

What is the method using artificial dermis (Alloderm, SureDerm)?

Its purpose is almost the same as cartilage grafting.

Artificial dermis (Alloderm) was created by processing human dermal tissue to address the inconvenience and time required to harvest conchal cartilage or septal cartilage, as well as the problems of scarring and deformity in the ear.

Because it is a biological material, it does not trigger rejection and can be grafted in anyone. Its advantages are a natural shape and almost no side effects.

Disadvantages of artificial dermis (Alloderm, SureDerm)

It cannot be used to raise the entire nasal bridge.
Some of the artificial dermis may be absorbed over time and sink.

Advantages of artificial dermis (Alloderm, SureDerm)

The surgery is simple and less expensive than cartilage grafting.
It is effective for slightly lifting or lengthening the nose tip.
No tape fixation is needed after surgery, so you can return to daily life immediately.
Because it is a biological material, side effects such as inflammation occur very rarely.
It is also effective for correcting curved areas of the nose.
If additional augmentation is desired later, more artificial dermis can be grafted.

What is the method using rib cartilage?

It is not a method used for ordinary augmentation rhinoplasty.

It involves harvesting and grafting a portion of the rib cartilage attached to the ribs.

It is mainly used to correct an upturned nose or raise the nasal bridge, but the disadvantage is that, unlike silicone, it does not look naturally shaped, and if you do not like the shape, it is impossible to remove, which is a major drawback.

It also leaves a large scar at the site where the rib cartilage was harvested.

Therefore, rib cartilage is not applied to routine rhinoplasty and is, in principle, used when the nose has been severely damaged by an accident and reconstruction with autologous tissue is needed.

In other words, it is used when tissue restoration is required due to tissue loss.

Using rib cartilage for simple augmentation is a very unreasonable method, so surgery should not be performed carelessly using rib cartilage.

Disadvantages of rib cartilage

In most cases, augmentation rhinoplasty using rib cartilage makes it difficult to achieve a natural nose shape.
Because rib cartilage must be harvested from the chest, it leaves a long scar on the chest.
If you do not like the shape, removal is impossible.
The surgery takes a long time and is very expensive.

What is the method using dermal fat?

Dermal fat is mainly harvested from the boundary area between the buttocks and thighs, and the epidermis is removed so that the dermis and fatty tissue are grafted together. It can be applied to people who are concerned about foreign materials.

Its drawbacks are that swelling lasts a long time and it is difficult to create the desired nose shape.

In most cases, a nose that has undergone dermal fat grafting does not look refined and often appears awkward, like a puffy nose.

It is also very difficult to remove if you do not like it.

Another drawback is that it leaves a large scar in the thigh area from which the dermal fat was harvested.

Disadvantages of dermal fat

In most cases, it is difficult to achieve a natural nose shape because the result tends to look swollen and awkward after surgery.
Because dermal fat must be harvested from the back of the thigh, it leaves a long scar on the back of the thigh.
If you do not like the shape, removal is almost impossible.
The surgery takes a long time and is expensive.

What is the method using microfat grafting?

This method involves harvesting fat from the lower abdomen with a syringe and then grafting it into the low bridge area using a syringe again.

Because only a syringe is used, no skin incision is needed at all, and unlike many other surgeries, you can resume activity immediately without needing tape after the procedure.

The disadvantages are that if the survival rate is low, an additional procedure is needed, and sometimes sufficient augmentation is not achieved as desired.

Disadvantages of microfat grafting

It is difficult to achieve a clear augmentation effect all at once like silicone.
If the survival rate drops after one procedure, a second procedure is needed.
It is difficult to apply when the nasal skin is thin or firm.
In general, it is difficult to apply when trying to raise the nostrils.

Advantages of microfat grafting

The cost is low and the procedure is simple.
It allows for a subtle and natural augmentation that does not look obvious.
There is little swelling, so you can return to daily life within a few days.
It can correct a crooked or contoured nose.

What are the problems with nose filler procedures?

■ Side effects such as inflammation occur frequently.

■ Nasal vessel blockage due to embolism can cause necrosis of the skin on the nasal bridge.

■ The filler may move or flow downward, causing nasal deformity.

■ Because fillers are absorbed or spread out, the augmentation effect is weak.

■ If you do not like the result, removal is very difficult.

■ If you later want correction with another method such as an implant or fat grafting, correction is difficult.

Main rhinoplasty procedures at our clinic ~

Microfat grafting

This method is applied when you want to raise the nasal bridge only slightly and naturally, or when the nose has contours or is crooked.

Artificial dermis (Alloderm, SureDerm) grafting

This method is used to supplement the shortcomings of conventional cartilage grafting.

Alloderm (SureDerm) is made by processing human skin, and it is designed so that it can be grafted into anyone without biological rejection, making it a material that can be used with confidence.

Like cartilage, it is mainly used only for nose tip surgery.

It has the advantage of allowing a simple operation when you want to slightly lift only the nose tip to create an upturned nose, or when the nose tip is short and you want to lengthen it a little.

Silicone insertion

Worldwide, the material that remains most in the spotlight for augmentation of the nasal bridge is the silicone implant.

Used by plastic surgeons for decades, its safety has been confirmed, it is easy to design the shape, and it has almost no side effects, so it is recognized as one of the best materials for augmentation rhinoplasty.

It is mainly applied to simple augmentation to raise the nasal bridge.

http://www.duhans.com