Indications for augmentation rhinoplasty with hyaluronic acid. As for hyaluronic acid nasal augmentation, I personally think that it is suitable for people whose nasal bridge is not very low as a whole, but is low or not smooth in some parts. If your nasal bridge is very low, it is recommended to use a prosthesis for augmentation rhinoplasty. For women with a low overall nasal bridge, if they must use hyaluronic acid for augmentation rhinoplasty, they need to inject a large amount of hyaluronic acid. As hyaluronic acid is a gel, its long-term stability is relatively poor. Although a large amount of hyaluronic acid can also produce amazing effects after surgery, it can appear next "Avatar" nose.

   Hyaluronic acid nasal augmentation can not solve all the defects of the nose, such as too round nose, hypertrophy of nasal wing, etc. In addition, it is prohibited to inject hyaluronic acid into the nose, otherwise it may lead to serious complications such as vascular embolism.   Personally, I think hyaluronic acid is more suitable for fine tuning the nose. If you are a bride to be or you have an important meeting to attend recently, hyaluronic acid micro plastic surgery is very suitable for you. Because hyaluronic acid needs to be injected once a year three Therefore, in addition to indications and complications, beauty seekers also need to consider the practical problem of burning money. Hyaluronic acid nasal augmentation is more suitable for people who are afraid of pain, busy and not poor in money.

   The cost of hyaluronic acid nasal augmentation. Hyaluronic acid nasal augmentation is usually enough. At present, legal hyaluronic acid is common ten Species, respectively imported four Species: Ruilan two No., Yiwan, Alive and Jo Yaden; And domestic six Seed: Run . Baiyan, Haiwei, Shuyan EME( Yimei ) Baonida, Fasili (Has anyone called Demales of South Korea Hyaluronic Acid? What are the legal Hyaluronic Acid in China at present? - Wang Shihu's answer). Different hyaluronic acid and different people may have different costs. The normal cost of the industry is about 3000-7000 element / It is generally impossible to lower than two thousand element / Branch.

   Hyaluronic acid nasal augmentation effect. Hyaluronic acid is a material that can be completely metabolized in human body, so its effect is reversible. Its metabolic cycle is about half a year, but in fact, four or five months after the operation, although the drug is still available, the effect has actually been unable to maintain, so in fact, in order to maintain the effect, it usually requires one year of injection three Times. So what is the effect of hyaluronic acid nasal augmentation? If you search on the Internet, you can find a lot of cases that make you feel excited, but if you are careful and reasonable enough, you will find that the preoperative and postoperative comparison or effect pictures that make you feel excited are not reliable, because the people in the photos obviously make up, and the photos also seem to be PS Yes, this obviously does not reflect the objective situation - think about how beautiful your girlfriend is in the wedding photos? What really reflects the effect of the operation is the preoperative and postoperative comparison in line with medical standards. The following is the case I quoted in the paper, which can be used as a reference for case selection and effect expectation.

thirty-three The nasal root and back of a female aged 35 years old are low, HA injection 1.0ml Perform augmentation rhinoplasty. a . Before injection; b Immediately after injection. (The picture is quoted from the Chinese Journal of Aesthetic and Plastic Surgery) The risks and complications of nasal augmentation with hyaluronic acid. If you want to solve your nasal defect for a long time, I still recommend nasal augmentation surgery. Even if you are a local tyrant and don't need money, I don't recommend long-term injection of hyaluronic acid. Because, although the trauma of hyaluronic acid nasal augmentation is much smaller than that of surgery, it does not seem to be risk-free as advertised by plastic surgery institutions. Most beauty seekers, including some inexperienced doctors, may think that injection of hyaluronic acid is as simple as "spanking" without technical content. In fact, this understanding is wrong, which also leads to some serious complications of intramuscular injection. In this regard, what are the risks of beauty products such as hyaluronic acid injection and face lifting? How is it different from intramuscular injection?

    The key point here is the high risk and complications of hyaluronic acid nasal augmentation ——The blood vessel is compressed or embolized. Hyaluronic acid may be injected into the blood vessel by mistake, but once it is injected into the blood vessel, it may lead to vascular embolism, which may lead to blindness, nose tip necrosis, upper lip partial necrosis, etc., and excessive local injection volume may cause vascular compression, and may also cause a certain degree of blood loss and necrosis. Hyaluronic acid augmentation rhinoplasty has more serious complications than augmentation rhinoplasty.

   about Hyaluronic acid nasal augmentation How do I feel about the effects, risks and complications of facial acupuncture and hyaluronic acid? There are more detailed answers in. If you want to know more, please click on the link. I just refer to the complication of vascular compression or embolism, hoping to draw your attention.   The blood vessel is compressed or embolized. Vascular obstruction is a serious complication of hyaluronic acid injection, which may lead to serious consequences and should be paid enough attention. Because of the abundant blood supply in the head and face and the developed collateral circulation, if a single vessel is blocked, it is not enough to cause serious consequences. Many factors often exist at the same time, including the accidental injection of filler into the vascular lumen, leading to lumen obstruction; Because the filling dose is too high, local tissue edema, compression of nearby blood vessels; The needle punctures the blood vessel wall, starts the endogenous coagulation pathway, forms thrombus, and further affects blood circulation; Local bleeding, hematoma, compression of nearby tissues, affecting blood supply.   The clinical manifestation of tissue necrosis is acute pain after injection, and then the local skin can see intricate reticular blue spots, sudden skin blisters, blood blisters, ulcers, and even full-thickness skin mucosa or muscle necrosis. Vascular obstruction * tends to occur between the eyebrows, at the tip of the nose and at the nasal wing. Once the filler enters the facial artery, it may flow into the eye or carotid artery, causing retinal artery embolism or cerebral embolism, resulting in stroke and blindness.   Therefore, to be familiar with the anatomy of the relevant injection area and the depth of injection is the key to prevent vascular embolism. Personally, adrenaline injection into the total trunk of the blood vessel before operation can shrink the blood vessel and reduce the probability of mistaking the blood vessel; Once signs of embolism occur, the injection should be stopped immediately, and vasodilators should be used to ensure oxygen supply to local tissues and relieve vascular compression as soon as possible.

In the same way, the non metabolizable materials like Abeff and Iveland are a little too big ——Long term is also its * major disadvantage. This non metabolizable material has various potential risks, and more importantly, it is difficult to clean it. If something goes wrong, it's very difficult to deal with it.  

Another method of nasal augmentation by injecting autologous fat is nasal augmentation. The nasal augmentation effect of autologous fat is not obvious, and I generally do not recommend it. In my opinion, autologous fat is more suitable for correction of low nasal root.   Illegal injections. You may have heard of some other injection materials for nasal augmentation, but I would like to emphasize one point here: Ormadine, artificial bone powder, liquid silica gel, microcrystalline porcelain and other common injections for nasal plastic surgery are expressly prohibited by the Ministry of Health and the Food and Drug Administration, but now some beauty salons and some plastic surgery institutions are still injecting illegally.   Microcrystalline porcelain, the so-called "pornographic" injection material, is legal in Taiwan and not approved by the mainland, but some hospitals are using it secretly. Now, let me talk about my attitude towards such injection materials.   After consulting microcrystalline porcelain, we learned that: The microcrystalline porcelain is a kind of biological soft ceramics, whose main structure and composition are calcium hydroxyapatite. Since calcium hydroxyapatite cannot be directly injected into the human body, it must be mixed with other liquid substances before injection. Microcrystalline porcelain is to suspend hydroxyapatite calcium in water and glycerine (USP) The gel shaped carrier formed by the invention can form the characteristics of semi-solid implant for injection.

Bone powder nasal augmentation has been popular in China for a long time, and its main component is hydroxyapatite, just like microcrystalline porcelain. Later, the Ministry of Health banned this material because it is easy to be broken by external force after being injected into the nose, and it is difficult to take out and will cause serious complications (such as skin redness, swelling, ulceration, difficulty in shaping, etc.) and many other defects. Therefore, does microcrystalline porcelain with the same composition have similar defects?   If you are not used to using hyaluronic acid for augmentation rhinoplasty after surgery, one injection of hydrolase can restore the original state. There is no antidote for microcrystalline porcelain nose augmentation. If you are not satisfied, it is difficult to take out and clean it because of its large size.    

II Let's talk about rhinoplasty.   Surgical rhinoplasty can be divided into ordinary rhinoplasty（ L Augmentation rhinoplasty), compound augmentation rhinoplasty（ L Type I silicone prosthesis or willow shaped silicone prosthesis + There are three kinds of surgical materials, namely, ear cartilage cushion nose tip, and comprehensive nasal augmentation (nasal augmentation based on autologous cartilage). The surgical materials mainly include silicone prosthesis (domestic, joint venture, imported), expanded body (domestic, imported), and autologous cartilage (nasal septal bone, costal cartilage, and ear cartilage).   L T-shaped prosthesis is a classic nasal augmentation method. According to different prostheses, the cost is about 3000-15000 Generally speaking, expanded prosthesis is more expensive than silicone prosthesis, and imported prosthesis is more expensive than domestic prosthesis. L Type A prosthesis is simple and effective, but now surgeons do not recommend it. The main reason is that the prosthesis will inevitably compress the skin of the nose, resulting in thinning of the skin of the nose, which will lead to reflection, redness of the nose, strong sense of steps of the prosthesis, parrot's beak deformity and other symptoms. * Severe cases may lead to nasal perforation. Because of these inevitable complications, L Type A prosthesis is usually short to three Years or longer ten It needs another operation in. But remember: skin tissue thinning is irreversible!  

Compound nose augmentation L The cost of the improved magician for augmentation rhinoplasty with type A prosthesis is about 1.5-3 Ten thousand. In order to prevent the nasal prosthesis from sliding down, the skin of the nose becomes thin and the nose turns red, the doctor takes part of the auricle cartilage of the patient under local anesthesia and sutures it to L The nose tip of the T-shaped prosthesis was implanted into the nose as a whole. The big problem with this practice is that there is a certain probability of absorption rate because of the poor blood supply of ear cartilage after transplantation. At present, plastic surgeons generally do not recommend placing prostheses at the tip of the nose. If there is no other problem with the nose, it is generally in the shape of willow leaf（ I The prosthesis cushions the bridge of the nose, and the ear cartilage modifies the tip of the nose (in this way, the blood supply of the ear soft bone is good). Comprehensive rhinoplasty is more commonly recommended by plastic surgeons at present, and the cost in the industry is about 3-8 10000, average four About 10000 yuan, poor foundation, material selection * * *, cost higher than eight It is also normal. The idea of comprehensive nose augmentation comes from the Dallas School of rhinoplasty, which is currently improved by Asian peers and suitable for Asians. Comprehensive augmentation rhinoplasty has changed the idea of using prostheses to augmentate the nose, instead of using autologous cartilage to augmentate the nose. Autogenous cartilage can change the nasal support structure, and the autogenous cartilage can survive. Therefore, if this operation is properly performed, it will not have the sequelae of traditional nose augmentation, such as redness, transparent reflection, and nasal perforation, and it can basically be done once and for all. Comprehensive rhinoplasty involves the source of autologous cartilage materials. The nasal septum is an ideal support rod, but Asians generally do not have enough bone mass than Europeans and Americans. However, if the bone mass in the nose is enough, the nose must be opened to know, and it is impossible to judge before surgery. There are two ways to solve the problem of insufficient bone mass of nasal septum: one is to take costal cartilage, which I used to do in the past, but according to my experience and peer feedback, there is probably costal cartilage 30% It is easy to deform, so now, except that there is really no bone in the nose to be taken, I generally do not use costal cartilage; In view of the defect of costal cartilage, the second method I have adopted is to use the nasal middle bone with some ear cartilage as the support rod. The simple ear cartilage is not supportive enough, but a small part of the ear cartilage combined with the nasal septum bone does not affect the support.  

In addition to these benefits, comprehensive augmentation rhinoplasty can comprehensively solve the problem of poor nasal shape. During the interview, I found that most of the women with nasal augmentation are not simply low bridge of the nose, but large nose, wide nose wing, nose facing up, etc. It is difficult to solve their problems with nasal augmentation alone, while the comprehensive nose reconstruction of nostrils, nasal wings, nasal columella, bridge of the nose, and nose can effectively solve this kind of bad nose shape.  

Then talk about the advantages and disadvantages of silicone prosthesis and expanded body.   Silicone prosthesis is much cheaper than expanded prosthesis, and it is very safe. Rejection rate and infection rate * It is rare and easy to carve, implant and remove (even if ten It is also easy to take out after ten years). The disadvantage of silicone prosthesis is that it is a foreign body to the human body, so after implantation, the human body will form a layer of capsule around the prosthesis, which may appear contracture in the later stage. In addition, because of poor histocompatibility, there may be obvious step feeling or prosthesis feeling in the later stage. The big problem of silicone prosthesis * is light transmission. The silicone can not be integrated into the nasal tissue, and the nasal skin of women is generally thin. Therefore, silicone prosthesis augmentation rhinoplasty will more or less reflect light.  

Expanded body, scientific name: polytetrafluoroethylene, * initially used for heart bypass surgery, and later used clinically Plastic surgery It is mainly used to fill the bridge of nose, jaw, temporal part, forehead and other parts. There are many micropores in the expansion body, which has high compatibility with human tissues. Human tissues can grow into the expansion body slowly. Therefore, the expansion effect is very natural, so natural that even professional doctors may not see it. It may be more troublesome than silicone prosthesis, but it is not a big problem for experienced surgeons. The problem of large expansion is the infection rate. During the operation, the doctor strictly implements the aseptic operation standard, which rarely causes infection. However, in the later stage, for example, patients often pick their noses, which may cause infection. Once infection occurs, only one piece can be taken out. According to literature reports and my observation, the infection rate of bulky body is about 3% Left and right* Later, the expanded prosthesis is more expensive than the silicone prosthesis. *My suggestion later is that, without considering the money, if you have no problem with your nose type, just a low bridge of nose, you can consider hyaluronic acid nasal augmentation. If you need surgery, you can either do not do it, or do comprehensive nasal augmentation if you want to do it.  

*Later, those who are interested in nose augmentation should remember one principle:   Three more surgeries on the tip of the nose (you don't want Michael ·Jackson's nose?), There is no problem with multiple operations on the back of the nose (the back of the nose is a hard bone, which can be operated many times), and hyaluronic acid cannot be used to shape the nose tip (hyaluronic acid blocking the blood vessels may lead to nasal ulceration). The above is only the basic knowledge of various rhinoplasty operations. If you really decide to do rhinoplasty, you need to do more homework. Otherwise, you lack the necessary knowledge. Your research hospitals and doctors are all in vain, and you are only fooled. Learn more about plastic surgery in Alibang!