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8/14/2019 Augmented Asian Rhinoplasty(Green Background)
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Augmented Asian RhinoplastyAugmented Asian Rhinoplasty
The Art and The ScienceThe Art and The Science
Past, Present andPast, Present andFutureFuture
ThaneeThanee
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Characteristics of AsianCharacteristics of Asian
nosenose Wash out dorsum or saddle deformityWash out dorsum or saddle deformity
Deficient tip projectionDeficient tip projection
Wide lobule, thick lobular skinWide lobule, thick lobular skin Abundant subcutaneous fatty tissueAbundant subcutaneous fatty tissue
Alar flaringAlar flaring
Retracted columellaRetracted columella
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Asian saddle noseAsian saddle nose
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Asian Rhinoplasty requiresAsian Rhinoplasty requires
Augmentation of dorsum areaAugmentation of dorsum area
Augmentation on top of lateral cartilage areaAugmentation on top of lateral cartilage area
Augmentation of columella-tip area for tipAugmentation of columella-tip area for tipprojection and increase nasal lengthprojection and increase nasal length
Refining the lobule/tip areaRefining the lobule/tip area
Decrease the width of the nostrilsDecrease the width of the nostrils
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Augmentation AsianAugmentation Asian
RhinoplastyRhinoplasty
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In theIn the oldold day of Asian rhinoplastyday of Asian rhinoplasty Injected liquid paraffin orInjected liquid paraffin or
liquid siliconeliquid silicone
L-shaped alloplasticL-shaped alloplastic
implant, mainlyimplant, mainly
silicone elastomer.silicone elastomer.
Rib autograft or homograft.Rib autograft or homograft.
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To the Present timeTo the Present time Novel design siliconeNovel design silicone
implant with tip protectionimplant with tip protectionusing ear, septal or lowerusing ear, septal or lower
lateral cartilage.lateral cartilage.
Autogenous costal cartilageAutogenous costal cartilagegraft.graft.
Autogenous ear cartilage graftAutogenous ear cartilage graftin multiple layers(onlay graft).in multiple layers(onlay graft).
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To the present timeTo the present time(continue)(continue)
Bioplastic.Bioplastic.
The weird technology:The weird technology:
hard silicone in solvent.hard silicone in solvent.
FabricatedFabricatedperichondrocartilageperichondrocartilagecomplexcomplex from bothfrom both
ears into auto-nasalears into auto-nasalbioprosthesis.bioprosthesis.
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What is theWhat is the perichondrocartilage complexperichondrocartilage complex??
Cartilage with intactCartilage with intact
perichondrium.perichondrium.
In asian rhinoplasty, weIn asian rhinoplasty, we
harvest this complex fromharvest this complex from
both external ears.both external ears.
The complex will functionThe complex will function
as aas a living tissueliving tissue when it iswhen it is
implanted in human body.implanted in human body.
Harvest
DesignFabricate
Finish
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From raw materials to finished bioprosthesisFrom raw materials to finished bioprosthesis
i h h bl f
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Bioprostheses correct the problems ofBioprostheses correct the problems of
silicone prosthesis in Asian rhinoplastysilicone prosthesis in Asian rhinoplasty
InfectionInfection
ProtrusionProtrusion
PerforationPerforation
i h h dBi th t th d
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Bioprostheses correct the dorsumBioprostheses correct the dorsum
injecton of liquid siliconeinjecton of liquid silicone
B tt
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B oprost eses n m sce aneousoprost eses n m sce aneousconditionsconditions
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Rhinoplasty
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..
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The future is comingThe future is coming
Regenerative medicine :Regenerative medicine :
In the future, tissue damages will be replace withIn the future, tissue damages will be replace with
tissue substitutes.tissue substitutes.
Tissue engineering:Tissue engineering:
Bioengineer and biomedical engineer make tissueBioengineer and biomedical engineer make tissue
substitutes as body parts and ready to use. No more donorsubstitutes as body parts and ready to use. No more donor
site morbidity and deformity at all.site morbidity and deformity at all.
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In cartilage tissue engineer labIn cartilage tissue engineer lab
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ConclusionConclusion
Silicone elastomer and new inert biomaterials still have place inSilicone elastomer and new inert biomaterials still have place inasian rhinoplasty.asian rhinoplasty.
Autogenous cartilage fabrication in the form of nasal prosthesisAutogenous cartilage fabrication in the form of nasal prosthesiswill replace and use more and more.will replace and use more and more.
Cartilage tissue engineering in the form of nasalCartilage tissue engineering in the form of nasal
prostheses will be used in the future.prostheses will be used in the future.
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