OBJECTIVETo investigate the clinical effect of steroids on reducing postoperative edema in rhinoplasty.

METHODSCochrane, Medline data, Pubmed date, were searched and updated on October 2013. Randomized controlled trials(RCTS) studies were included to assess the efficacy of steroids on decreasing postoperative edema after rhinoplasty. The methodological quality of the included studies was evaluated, and date analyses were performed using the Cochrane Collaboration's software RevMan 5.2.

RESULTSA total of 4 RCTS involved 172 patients with rhinoplasty, including 87 patients in the experimental group( steroid) and 85 paitents in control group (placebo). Meta analysis results showed the edema in experimental group was significantly less than that in the control group on postoperative day 1 and 3 (P < 0.01), while the difference was not significant on postoperative day 7 (P = 0.19).

CONCLUSIONSPerioperative application of steroid in rhinoplasty can significantly reduce periorbital edema in the first postoperative day. The edema can completely be relieved after application of steroid for 3 days. It is a safe and effective way to reduce the postoperative edema.

Edema ; drug therapy ; etiology ; Humans ; Randomized Controlled Trials as Topic ; Rhinoplasty ; adverse effects

BACKGROUNDBulbous nasal tips and lower dorsa are common facial features in Chinese people, and surgery to reshape these is frequently requested. The use of silicone implants in rhinoplasty has been widely used in China for many years, but is not suitable for patients seeking Caucasian tip shapes. The creation of an excessively high tip supported only by a silicone implant inevitably leads to implant extrusion. Although many rhinoplasty techniques have been used in Caucasian patients, there is currently no suitable method for Chinese patients, whose anatomy differs from that of Caucasians. The present study was aimed to investigate the clinical outcome of a novel method of rhinoplasty in Chinese people.

METHODSEighty patients underwent rhinoplasty using our method between 2002 and 2006. We classified the patients into three types, according to the distance between tip defining points, and used different techniques accordingly. Furthermore, an innovative cartilage carving method and a tip fibro-fatty tissue flap were designed and combined with traditional techniques, such as insertion of silicone implant, cartilage grafts, suture techniques and cephalic trimming to reshape the nasal contours. The followup period was 10 - 60 months (average, 21 months).

RESULTSRemarkable modifications in nasal contours were achieved. No complications developed in any of the 80 patients. Seventy-eight patients were satisfied with the results. The outcomes remained unchanged over time.

CONCLUSIONOur method is effective and suitable for the treatment of Chinese patients with lower dorsa and bulbous nasal tips.

Adult ; Asian Continental Ancestry Group ; Female ; Humans ; Male ; Nose ; surgery ; Rhinoplasty ; adverse effects ; methods ; Young Adult

PURPOSE: Augmentation rhinoplasty using alloplastic materials is a relatively common procedure among Asians. Silicon, expanded polytetrafluoroethylene (Gore-tex(R)), and porous high density polyethylene (Medpor(R)) are most frequently used materials. This study was conducted to analyze revisional rhinoplasty cases with alloplastic materials, and to investigate the usage of alloplastic materials and their complications. We also reviewed complications caused by various materials used in plastic surgery while operating rhinoplasty. MATERIALS AND METHODS: We report 581 cases of complications rhinoplasty with alloplastic implants and review of the literature available to offer plastic surgeons an overview on alloplastic implant-related complications. RESULTS: Among a total 581 revisional rhinoplasty cases reviewed, the alloplastic materials used were silicone implants in 376, Gore-tex(R) in 183, and Medpor(R) in 22 cases. Revision cases and complications differed according to each alloplastic implant. CONCLUSION: Optimal alloplastic implants should be used in nasal structure by taking into account the properties of the materials for the goal of minimizing their complications and revision rates. A thorough understanding of the mechanism involved in alloplastic material interaction and wound healing is the top priority in successfully overcoming alloplastic-related complications.
Asian Continental Ancestry Group ; *Biocompatible Materials/adverse effects ; Humans ; Polyethylene ; Polyethylenes ; *Polytetrafluoroethylene ; Postoperative Complications ; Prosthesis Implantation/*methods ; Rhinoplasty/*methods ; Silicones ; Treatment Outcome

OBJECTIVE: To explore the feasibility, option of surgical method and surgery opportunity of local flap reconstruction in nasal defects due to severe infection after rhinoplasty. METHOD: The clinical datum of eleven patients, who had 15 cases of local flap reconstruction due to severe infection after rhinoplasty, were analyzed retrospectively. The lesions included defects of nasal dorsum, nasal tip and anterior-nare-vestibular fistula. Areas of defects ranged from 1.5 cm x 1.2 cm to 2.0 cm x 2.5 cm and fistula diameters fell between 0.6 cm and 0.9 cm. Based on the principal of nasal aesthetic sub-unit, nasal defects were restored with local flaps, such as nasal dorsum flaps, rhomboid flaps and nasal columella-tip flaps. The early changes and the maintenances of nasal contour after reconstruction were observed. RESULT: All 15 reconstructions were carried out 2 weeks after control of infection, and stage-I recovery was achieved in all the cases. In the follow-up periods from 4 to 27 months, all the flaps survived. only 2 cases had distortion of nasal tips, however, they were recovered with subcutaneous injection restoration; the other cases received satisfactory nasal contour where the flaps matched well with the neighbor skin in color, texture and extent of actinic dermatitis. CONCLUSION Based on the principal of nasal aesthetic sub-unit, the individualized early local flap reconstruction would have good effect on nasal function and aesthetics, which will restore self-confidence of the patients as soon as possible.
Adult ; Female ; Humans ; Infection ; complications ; Male ; Postoperative Complications ; surgery ; Reconstructive Surgical Procedures ; methods ; Rhinoplasty ; adverse effects ; Skin Transplantation ; Surgical Flaps ; Young Adult

Development of a cystic mass on the nasal dorsum is a very rare complication of aesthetic rhinoplasty. Most reported cases are of mucous cyst and entrapment of the nasal mucosa in the subcutaneous space due to traumatic surgical technique has been suggested as a presumptive pathogenesis. Here, we report a case of dorsal nasal cyst that had a different pathogenesis for cyst formation. A 58-yr-old woman developed a large cystic mass on the nasal radix 30 yr after augmentation rhinoplasty with silicone material. The mass was removed via a direct open approach and the pathology findings revealed a foreign body inclusion cyst associated with silicone. Successful nasal reconstruction was performed with autologous cartilages. Discussion and a brief review of the literature will be focused on the pathophysiology of and treatment options for a postrhinoplasty dorsal cyst.
Cysts/diagnosis/pathology/surgery ; Female ; Foreign Bodies/diagnosis/*etiology ; Humans ; Microscopy, Electron, Scanning ; Middle Aged ; *Nose/pathology ; Nose Diseases/diagnosis/etiology/pathology ; Rhinoplasty/*adverse effects ; Tomography, X-Ray Computed