一年一度的國際整形美容外科醫學會（International Society of Aesthetic Plastic Surgery, ISAP）年度教育課程研討會，於2015年9月5日至2015年9月6日在台灣盛大舉行，會議地點是台北圓山大飯店。曾醫師今年受邀在大會做隆鼻手術的演講，演講題目是「Augmentation Rhinoplasty in Asian People」。
Augmentation Rhinoplasty in Asian People
Wen-Sun Tseng, M.D.
Aphrodite Fashion Clinic (plastic surgery)
Rhinoplasty is a highly specialized field that requires much knowledge and skill on the surgeon to have successful result. The concepts of beautiful nose are different from Asians and Caucasians with respect to ethnic and cultural backgrounds, anatomy of the face and nose, and psychological and aesthetic needs of the patients. Asian rhinoplasty is one of the most common aesthetic procedures in Taiwan. The specialty of Asian rhinoplasty surgery has grown and evolved with the refinement of many innovative techniques and the creation of new procedures.
Orientals have flatter noses than Caucasians because of insufficient bone and cartilage support for oriental nose. The common concerns of Asian patients are bulbous tip, wide and low dorsum, retracted columella, flat nostril, weak and thin cartilage, and thick skin (thick subcutaneous tissue). We can divide the problems of oriental noses into 5 groups: short nose. bulbous nose, saddle nose, retracted columella, and insufficient nasal tip projection.
For the augmentation of oriental nose, alloplastic material (L-shape silicone) have been widely used for more than 30 years. Therefore secondary revision procedure is also increased because L-silicone implant are prone to exposure, infection, and displacement. And also in case of lack of skin envelope and short nasal framework, it is not enough to get good result by performing augmentation using L-shape silicone implant. Inadequate surgical technique and overaggressive augmentation with silicone implants have led to the potential of implant extrusion through the incision site, or, worse yet, through the overlying tip skin.
Which method is good for oriental nose? The critical points for Asian rhinoplasty are selecting appropriate grafting material, control of nasal tip projection, and precise control of dorsal height. I would like to present my cases and concepts!