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Augmented Asian Rhinoplasty

The Art and The Science

Past, Present and
Future

Thanee
Characteristics of Asian
nose
 Wash out dorsum or saddle deformity
 Deficient tip projection
 Wide lobule, thick lobular skin
 Abundant subcutaneous fatty tissue
 Alar flaring
 Retracted columella
Asian saddle nose
Asian Rhinoplasty requires
 Augmentation of dorsum area
 Augmentation on top of lateral cartilage area
 Augmentation of columella-tip area for tip
projection and increase nasal length
 Refining the lobule/tip area
 Decrease the width of the nostrils
Augmentation Asian
Rhinoplasty
In the old day of Asian rhinoplasty
 Injected liquid paraffin or
liquid silicone

 L-shaped alloplastic
implant, mainly
silicone elastomer.

 Rib autograft or homograft.
To the Present time
 Novel design silicone
implant with tip protection
using ear, septal or lower
lateral cartilage.

 Autogenous costal cartilage
graft.

 Autogenous ear cartilage graft
in multiple layers(onlay graft).
To the present time (continue)
 Bioplastic.
The weird technology:
hard silicone in solvent.

 Fabricated
perichondrocartilage
complex from both
ears into auto-nasal
bioprosthesis.
What is the perichondrocartilage complex?

 Cartilage with intact
perichondrium.

 In asian rhinoplasty, we Finish Harvest
harvest this complex from
both external ears.

 The complex will function
as a living tissue when it is
implanted in human body. Fabricate Design
From raw materials to finished bioprosthesis
Bioprostheses correct the problems of
silicone prosthesis in Asian rhinoplasty
 Infection

 Protrusion

 Perforation
Bioprostheses correct the dorsum
injecton of liquid silicone
Bioprostheses in miscellaneous
conditions
Bioprostheses and Asian
Rhinoplasty
ขยายความจาก มติ
ชน สุดสัปดาห์
โปรเฟสเซอร์ แวร์เนอร์ มางก์ จาก รพ. โบเก็นเซ

ซึ่งมีช่ ือเสียงทางศัลยกรรมตกแต่งจมูกได้สวย
ที่สุดคนหนึ่ งได้กล่าวว่า

“ กระดูกอ่อนที่หู เป็ นวัสดุช้ันยอด
สำาหรับการตกแต่งจมูกใหม่ ไม่ใช่ซล ิ ิ
โคน”
The future is coming
 Regenerative medicine :
In the future, tissue damages will be replace with
tissue substitutes.

 Tissue engineering:
Bioengineer and biomedical engineer make tissue
substitutes as “body parts” and ready to use. No more donor
site morbidity and deformity at all.
In cartilage tissue engineer lab
Conclusion

 Silicone elastomer and new inert biomaterials still have place in
asian rhinoplasty.

 Autogenous cartilage fabrication in the form of nasal prosthesis
will replace and use more and more.

 Cartilage tissue engineering in the form of nasal
prostheses will be used in the future.