Objective:To investigate the complications and related etiologies after immediate silicone implant and immediate two-stage tissue expander/implant breast reconstruction.Methods:A retrospective study was conducted in 23 patients who underwent implant or tissue expander/implant breast reconstruction surgery from June 2016 to October 2019. The etiology, medical history and clinical symptoms of each patient were analyzed and related treatments were carried out depending on its complication.Results:All patients were followed up for 3-12 months after surgery. Among the 23 patients, a total of 8 patients had different types of postoperative complications. Partial necrosis of the nipple-areola complex occurred in 1 case, postoperative infection in 2 cases, 2 patients experienced deviation of the implant or tissue expander and displacement of the nipple-areola complex in 3 cases. All complications were treated accordingly, and a good therapeutic effect was finally maintained.Conclusions:For patients with complications after immediate silicone implant and two-stage tissue expander/implant breast reconstruction, treatment should be carried out according to the causes of complications in time. In this way, patient can get better prognosis.

Objective:To evaluate the effect of preoperative 3D simulation on the evaluation of rhinoplasty.Methods:From December 2017 to March 2019, patients in the Department of Burn and Plastic Surgery of the Second Xiangya Hospital of Central South University were randomly selected as the research subjects. According to whether they had received 3D simulation before surgery, they were divided into the experimental group (after 3D simulation before comprehensive surgery) and the control group (without 3D simulation before comprehensive surgery). Visual analogue scale (VAS) and Rhinoplasty Outcomes Evaluation (ROE ) questionnaires were used to evaluate the satisfaction of all patients preoperative and one month after surgery.Results:At the beginning of this study, a total of 97 cases were included, 97 cases were given questionnaires, and 60 cases were effectively recovered, 30 cases in each group.There was statistical significance in the improvement of the postoperative VAS scores between the experimental group and the control group ( P<0. 05). The mean improvement in the experimental group was (4. 10±0. 88) points, while the mean improvement in the control group was (2. 53±0. 73) points. There was statistical significance in the improvement of the postoperativeROE satisfaction scores between the two groups. The average preoperative satisfaction score of the experimental group was (29. 5±9. 7) points, which increased to (77. 3±13. 7) points after surgery. In the control group, the average satisfaction score was (30. 4±11. 3) points before surgery and increased to (62. 7±23. 4) points after surgery. Conclusions:3D simulation before nasal synthesis can improve the postoperative satisfaction of patients.VAS and ROE questionnaires are good tools for evaluating the effect of comprehensive rhinoplastic surgery.

Objective:To evaluate the effect of preoperative 3D simulation on the evaluation of rhinoplasty.Methods:From December 2017 to March 2019, patients in the Department of Burn and Plastic Surgery of the Second Xiangya Hospital of Central South University were randomly selected as the research subjects. According to whether they had received 3D simulation before surgery, they were divided into the experimental group (after 3D simulation before comprehensive surgery) and the control group (without 3D simulation before comprehensive surgery). Visual analogue scale (VAS) and Rhinoplasty Outcomes Evaluation (ROE) questionnaires were used to evaluate the satisfaction of all patients preoperatively and one month after surgery.Results:At the beginning of this study, a total of 97 cases were included. 97 cases were given questionnaires, and 60 cases were effectively recovered.There were 30 cases in each group. There was statistical significance in the improvement of the postoperative VAS scores between the experimental group and the control group ( P<0.05). The mean improvement in the experimental group was (4.10±0.88) points, while the mean improvement in the control group was (2.53±0.73) points. There was statistical significance in the improvement of the postoperative ROE satisfaction scores between the two groups. The average preoperative satisfaction score of the experimental group was (29.5±9.7) points, which increased to (77.3±13.7) points after surgery.In the control group, the average satisfaction score was (30.4±11.3) points before surgery and increased to (62.7±23.4) points after surgery. Conclusions:3D simulation before nasal synthesis can improve the postoperative satisfaction of patients. VAS and ROE questionnaires are good tools for evaluating the effect of comprehensive rhinoplastic surgery.

Objective:To evaluate the effect of preoperative 3D simulation on the evaluation of rhinoplasty.Methods:From December 2017 to March 2019, patients in the Department of Burn and Plastic Surgery of the Second Xiangya Hospital of Central South University were randomly selected as the research subjects. According to whether they had received 3D simulation before surgery, they were divided into the experimental group (after 3D simulation before comprehensive surgery) and the control group (without 3D simulation before comprehensive surgery). Visual analogue scale (VAS) and Rhinoplasty Outcomes Evaluation (ROE ) questionnaires were used to evaluate the satisfaction of all patients preoperative and one month after surgery.Results:At the beginning of this study, a total of 97 cases were included, 97 cases were given questionnaires, and 60 cases were effectively recovered, 30 cases in each group.There was statistical significance in the improvement of the postoperative VAS scores between the experimental group and the control group ( P<0. 05). The mean improvement in the experimental group was (4. 10±0. 88) points, while the mean improvement in the control group was (2. 53±0. 73) points. There was statistical significance in the improvement of the postoperativeROE satisfaction scores between the two groups. The average preoperative satisfaction score of the experimental group was (29. 5±9. 7) points, which increased to (77. 3±13. 7) points after surgery. In the control group, the average satisfaction score was (30. 4±11. 3) points before surgery and increased to (62. 7±23. 4) points after surgery. Conclusions:3D simulation before nasal synthesis can improve the postoperative satisfaction of patients.VAS and ROE questionnaires are good tools for evaluating the effect of comprehensive rhinoplastic surgery.

Objective:To evaluate the effect of preoperative 3D simulation on the evaluation of rhinoplasty.Methods:From December 2017 to March 2019, patients in the Department of Burn and Plastic Surgery of the Second Xiangya Hospital of Central South University were randomly selected as the research subjects. According to whether they had received 3D simulation before surgery, they were divided into the experimental group (after 3D simulation before comprehensive surgery) and the control group (without 3D simulation before comprehensive surgery). Visual analogue scale (VAS) and Rhinoplasty Outcomes Evaluation (ROE) questionnaires were used to evaluate the satisfaction of all patients preoperatively and one month after surgery.Results:At the beginning of this study, a total of 97 cases were included. 97 cases were given questionnaires, and 60 cases were effectively recovered.There were 30 cases in each group. There was statistical significance in the improvement of the postoperative VAS scores between the experimental group and the control group ( P<0.05). The mean improvement in the experimental group was (4.10±0.88) points, while the mean improvement in the control group was (2.53±0.73) points. There was statistical significance in the improvement of the postoperative ROE satisfaction scores between the two groups. The average preoperative satisfaction score of the experimental group was (29.5±9.7) points, which increased to (77.3±13.7) points after surgery.In the control group, the average satisfaction score was (30.4±11.3) points before surgery and increased to (62.7±23.4) points after surgery. Conclusions:3D simulation before nasal synthesis can improve the postoperative satisfaction of patients. VAS and ROE questionnaires are good tools for evaluating the effect of comprehensive rhinoplastic surgery.

Objective: To investigate the clinical effect of diced cartilage in correcting nasal alar base depression after cleft lip surgery. Methods: A retrospective study was conducted in 15 patients of nasal deformity after lip surgery from January 2018 to January 2019. All the patients were taken from autologous costal cartilage to reconstruct the outline of nasal malformation, and the remaining autologous costal cartilage was cut into 0.5-1.0 mm pieces and filled into the basilar lacunar space of the nasal alar by the 1 ml syringe whose anterior needle nipples was removed. The effects of visual images before and after operation were compared and analyzed by Adobe Photoshop CS6 software. The patients were followed up for 6-15 months (mean 10months). The satisfaction and complications of the patients were investigated. Results: The nasal alar base was significantly elevated and the outline of the nasal deformity was improved in 15 patients after operation. The overall effect was satisfactory and no obvious complications were found. No obvious absorption was found in the follow-up. Conclusions The application of diced cartilage to correct the nasal alar base depression after cleft lip surgery was a feasible method with important clinical value. It advanced in taking good use of the remaining cartilage and reducing the damage to both the donor and recipient area.

Objective:To introduce a surgical technique applied in autologous costal cartilage rhinoplasty described as the endonasal incision combined with umbrella-like graft.Methods:From February 2018 to May 2019, a total of 52 patients (48 females and 4 males) were enrolled and underwent rhinoplasty operation with bilateral intranasal incision for the construction of umbrellal scaffolds in Department of Burn and Plastic Surgery of the Second Xiangya Hospital. During the operation, bilateral inferior lateral cartilages were fully separated and septal cartilages were exposed. Umbrellal-like scaffolds were built to correct nasal aesthetic defects such as nasal columellar shrinkage and insufficient nasal tip protrusion. During the process of follow-up, all the patients were photographed and were asked to complete the the postoperative satisfaction survey by means of an online link or over the phone.Results:The preoperative nasal aesthetic defection was greatly improved. There is no the temporary complications including infection and bleeding. 30 patients who completed follow-up for 6 months at least and completed postoperative satisfaction survey were included in the case series. The measurements (average): The nasofrontal angle was measured as 141.29°±5.61°preoperation and 137.67°±5.27°postoperation. The nasolabial angle was measured as 89.53°±10.56°preoperation and 94.90°±5.88°postoperation , The nasal tip angle was measured as 86.60°±7.09°preoperation and 80.42°±5.47° postoperation, Columellar-lobular angle was measured as 48.82°±7.32°preoperation and 44.63°±2.51°postoperation , The tip projection-nasal length index was measured as 0.48±0.07 preoperation and 0.54±0.07 postoperation. Columellar-lobular length index was measured as 1.74±0.36 preoperation and 1.22±0.21 postoperation, There were significantly statistical differences between preoperative and postoperative measures. The photograph showed the location and reflection of nasal tip have remained stable, no upward or twist trend occurred. According to questionaire results, postsurgical swelling relieved in all cases within the first 3 to 6 weeks. No prolonged functional sequelae occured, Most of patients were satisfied with the aesthetic and functional results.Conclusions:Endonasal incision combined with umbrella-shape graft facilitates the operation, Bilateral endonasal incision allowed us to evaluate the reestablished nasal tip directly and adjust tip projection with convenience, there’s no columella scar left.

Objective:To explore the application of bilateral autogenous auricular concha cartilage graft in the construction of nasal tip cartilage complex in comprehensive rhinoplasty.Methods:From January 2016 to June 2019, a total of 521 rhinoplasty patients in the Second Xiangya Hospital and in the Health Medical Cosmetic Hospital received the operation, including 310 patients with primary rhinoplasty and 211 patients with secondary rhinoplasty. There were 12 males and 509 females, aged 18-53 years. Contracted nose patients with severe tissue destruction were excluded. The operation method: the bilateral auricular concha cartilage was cut and combined, including the nasal columella support graft, the anti derotation graft and the cap graft, and the combination of the nasal tip framework complex was constructed to shape the nasal tip framework. At the same time, the expanded polytetrafluoroethylene or silicone prosthesis was carved into willow leaf shape to elevate the bridge of the nose. Patients were followed up after operation. Physicians, patients and a third party were asked to evaluate the preoperative and postoperative photos of more than 6 months to evaluate the surgical effect. The results suggested that the three parties were regarded as significantly effective, two parties satisfied as effective, one party satisfied as average, all dissatisfied as poor; postoperative complications such as infection and prosthesis exposure were judged as invalid. At the same time, the changes of nose tip height and nose length were measured.Results:521 patients in this group got satisfactory appearance effect immediately after operation. After 6-24 months follow-up, the shape of the nose tip remained good, the color of blood circulation was normal, the appearance of the nose tip was natural and beautiful, three-dimensional and straight. Among the 521 cases, 471 cases were significantly improved, 30 cases were improved, 15 cases were acceptable and other 5 cases were poor. The satisfaction rate was 96% (501/521). The average height of nasal tip was(3.5±0.3) mm higher than that before operation. The average length of nose was(4.9±0.4) mm longer than that before operation.Conclusions:The combination of auricular concha cartilage framework and silica gel prosthesis or expanded polytetrafluoroethylene can be used as a routine method for primary rhinoplasty and secondary rhinoplasty.

Objective:To introduce a surgical technique applied in autologous costal cartilage rhinoplasty described as the endonasal incision combined with umbrella-like graft.Methods:From February 2018 to May 2019, a total of 52 patients (48 females and 4 males) were enrolled and underwent rhinoplasty operation with bilateral intranasal incision for the construction of umbrellal scaffolds in Department of Burn and Plastic Surgery of the Second Xiangya Hospital. During the operation, bilateral inferior lateral cartilages were fully separated and septal cartilages were exposed. Umbrellal-like scaffolds were built to correct nasal aesthetic defects such as nasal columellar shrinkage and insufficient nasal tip protrusion. During the process of follow-up, all the patients were photographed and were asked to complete the the postoperative satisfaction survey by means of an online link or over the phone.Results:The preoperative nasal aesthetic defection was greatly improved. There is no the temporary complications including infection and bleeding. 30 patients who completed follow-up for 6 months at least and completed postoperative satisfaction survey were included in the case series. The measurements (average): The nasofrontal angle was measured as 141.29°±5.61°preoperation and 137.67°±5.27°postoperation. The nasolabial angle was measured as 89.53°±10.56°preoperation and 94.90°±5.88°postoperation , The nasal tip angle was measured as 86.60°±7.09°preoperation and 80.42°±5.47° postoperation, Columellar-lobular angle was measured as 48.82°±7.32°preoperation and 44.63°±2.51°postoperation , The tip projection-nasal length index was measured as 0.48±0.07 preoperation and 0.54±0.07 postoperation. Columellar-lobular length index was measured as 1.74±0.36 preoperation and 1.22±0.21 postoperation, There were significantly statistical differences between preoperative and postoperative measures. The photograph showed the location and reflection of nasal tip have remained stable, no upward or twist trend occurred. According to questionaire results, postsurgical swelling relieved in all cases within the first 3 to 6 weeks. No prolonged functional sequelae occured, Most of patients were satisfied with the aesthetic and functional results.Conclusions:Endonasal incision combined with umbrella-shape graft facilitates the operation, Bilateral endonasal incision allowed us to evaluate the reestablished nasal tip directly and adjust tip projection with convenience, there’s no columella scar left.

Objective:To explore the application of bilateral autogenous auricular concha cartilage graft in the construction of nasal tip cartilage complex in comprehensive rhinoplasty.Methods:From January 2016 to June 2019, a total of 521 rhinoplasty patients in the Second Xiangya Hospital and in the Health Medical Cosmetic Hospital received the operation, including 310 patients with primary rhinoplasty and 211 patients with secondary rhinoplasty. There were 12 males and 509 females, aged 18-53 years. Contracted nose patients with severe tissue destruction were excluded. The operation method: the bilateral auricular concha cartilage was cut and combined, including the nasal columella support graft, the anti derotation graft and the cap graft, and the combination of the nasal tip framework complex was constructed to shape the nasal tip framework. At the same time, the expanded polytetrafluoroethylene or silicone prosthesis was carved into willow leaf shape to elevate the bridge of the nose. Patients were followed up after operation. Physicians, patients and a third party were asked to evaluate the preoperative and postoperative photos of more than 6 months to evaluate the surgical effect. The results suggested that the three parties were regarded as significantly effective, two parties satisfied as effective, one party satisfied as average, all dissatisfied as poor; postoperative complications such as infection and prosthesis exposure were judged as invalid. At the same time, the changes of nose tip height and nose length were measured.Results:521 patients in this group got satisfactory appearance effect immediately after operation. After 6-24 months follow-up, the shape of the nose tip remained good, the color of blood circulation was normal, the appearance of the nose tip was natural and beautiful, three-dimensional and straight. Among the 521 cases, 471 cases were significantly improved, 30 cases were improved, 15 cases were acceptable and other 5 cases were poor. The satisfaction rate was 96% (501/521). The average height of nasal tip was(3.5±0.3) mm higher than that before operation. The average length of nose was(4.9±0.4) mm longer than that before operation.Conclusions:The combination of auricular concha cartilage framework and silica gel prosthesis or expanded polytetrafluoroethylene can be used as a routine method for primary rhinoplasty and secondary rhinoplasty.