고법민·강상윤·유영천·양원용
경희대학교
의과대학 성형외과학교실
Anatomical
Nasal Tip Plasty with Autogenous Cartilage Graft
Bub
Min Ko, M.D., Sang Yoon Kang, M.D., Young Cheun
Yoo, M.D., Won Yong Yang, M.D.
Department of
Plastic and Reconstructive Surgery,
College
of Medicine, KyungHee University, Seoul, Korea
Augmentaion
rhinoplasty is one of the most common aesthetic
surgery in Korea. Plastic surgeons have been more
interested in not only simple augmentation of nasal
dorsum, but making more beautiful and natural nasal
tip.
In
the people who has depressed nasal bridge with round
and blunted tip, simple augmentation of the nasal
dorsum with silicone or Gore-Texⓡ implants could
aggravate the tip's disfigurement, so the need for
tip plasty has been more emphasized in those persons.
There
have been used two traditional techniques in endonasal
autogenous cartilage tip graft br increasing tip
projection, Sheen's shield graft and Peck's onlay
graft. But these techniques have several disadvantages
such as displacement, visibility of graft margin
and flattening of infralobule. The most criticizable
problem is that these grafts have limitation in
producing the natural and anatomical tip contour.
we
have done 45 consecutive nasal tip plasties using
anatomically-shaped cartilage grafts which was developed
from the idea of combination of Sheen's shield and
Peck's onlay graft. we followed up the patients
from 2 to l4 months. Most patients have been very
satisfied with the results and no serious complications
were noted.
Author's
graft was designed to minimize displacement by stable
placement on both alar domal and lobular segments,
minimize graft visibility by increasing graft contact
to nasal tip skin, manipulate the cephalo-caudal
length by modification of onlay thickness and most
of all, reproduce the anatomical tip projection
and contour.
Key
words : Tip plasty, Shield graft, Onlay graft, Rhinoplasty |
