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今天這集接續上集內容，要帶來
#結構式隆鼻 #多段式隆鼻 中，針對鼻背鼻樑墊高
使用的 #人工材質假體 #卡麥拉 進行解析其 #優缺點 與建議，並且也會介紹 #人體材質
#自體肋骨 #異體肋骨 拿來使用 #墊高鼻背、#鼻樑 有什麼差異跟以及優缺點？
希望大家會喜歡
🎥完整版連結：https://youtu.be/tZ7H2Sz4DNo
#醫美 #整形 #整形外科 #邱大睿
#邱大睿邱醫師邱神手 #熱愛生活釋放多面向的自己 #look鹿克 #GoreTex #二代矽膠隆鼻 #醫美知識 #假體隆鼻 #nosejob
《鼻重修手術策略的重要性》
很多鼻重修的患者，前後經歷過許多次手術。從簡單的L型隆鼻，到現在的結構式隆鼻，不論多次手術的原因為何，裡面組織的破壞與手術難度肯定是增加許多。
手術前的3D CT評估，與手術策略息息相關。能制定出令人放心的策略，在醫病互信的前提進行手術，才能克服萬難，達到安全又理想的鼻型😄
#cosmetic #plasticsurgery #asethetic
#movie #series #drama #dramakorea #squidgame #strategy #nosejob #rhinoplasty #rhinoplasyspecialist #squidgame #美容 #整容 #鼻整形 #鼻修復 #鼻重修 #魷魚遊戲 #拔河 #no1nosetaipei
<<異體真皮吸收率半年追蹤！！40年矽膠鈣化鼻重修經驗分享>>
Ｃ女士為矽膠假體隆鼻四十年以上患者，在近20年因為矽膠假體不斷鈣化，鈣化點突出鼻樑兩側造成疼痛，因外觀與擔心鼻樑兩側鈣化點穿出前來就診，門診評估時發現矽膠假體幾乎完全被鈣化包圍，鼻樑兩側也有鈣化凸出物幾乎穿透鼻樑，造成戴眼鏡時壓迫不適感。
鼻重修手術規劃方向為
1. 自體肋軟骨重建鼻中膈延長鼻頭
2. 清除矽膠與莢膜鈣化
3. 異體真皮鼻樑重建
術後半年Ｃ小姐恢復良好，鼻樑高度利用異體真皮重建也未有太多吸收。整體鼻樑高度接近當初矽膠假體鼻高度，鼻頭則更為延長。鼻孔不對稱部分得到相對改善，皮膚因為原本鈣化突出引起的刺痛也得到緩解，術後相當滿意。
來複習一下矽膠本身優缺點與大規模鈣化時的解決方式：
硅膠本身優點：矽膠應用在人體已有很長時間，具有異物反應少，雕刻簡單，長時間放至於人體不會有形態變化的優點，矽膠表面形態變化很多，也能讓患者朋友選擇適合自己的假體型態，甚至一些鼻模公司針對特定國家族群研發適合他們的鼻模型態。鼻子皮膚較厚的患者，也能藉由矽膠假體作出較好的支撐讓鼻子型態較為好看。
矽膠本身缺點：假體必定有感染風險，置於過薄的皮膚可能有透光問題。矽膠假體植入人體一段時間後會產生莢膜，莢膜纖維化帶來皮膚變形與鈣化，植入鼻尖部可能有穿出皮膚等疑慮。
根據Dr Jung Dong Hak (鄭東學院長）與Bum Ryul Kim 發表在2007年PRS(Plastic and Reconstructive Surgery) 整形外科醫學期刊的論文顯示，矽膠隆鼻手術後15年發生鈣化機率達到100%。鈣化本身，屬於一個材料正常發展緩慢漸進的現象，鈣化不多不影響外觀時，不會為患者帶來外觀上的困擾，長時間累積到外觀影響時，則有需要更換材料改善外觀。
如果矽膠假體產生的莢膜組織過厚且莢膜中鈣化嚴重，手術中會以清除鈣化與移除假體為目標。此時皮膚會有過薄可能，為避免再次假體植入會有透光或是假體感過重情形，可以搭配自體或是異體軟組織（如異體真皮或是自體筋膜）增加皮膚厚度。再次植入材料也儘量以不產生莢膜材料為主（如膨體(Goretex或稱ePTFE）或是自體真皮脂肪片或異體真皮為主。同時建議手術前利用3D電腦斷層定位鈣化點的分佈，手術中利用手術放大鏡詳細確認清除部位，並保持表皮完整，尤其超過20年以上嚴重鈣化患者，鼻樑皮膚可能已經過薄，減少表皮傷害乃當務之急。
如果患者朋友們仍然比較喜歡矽膠假體鼻模的型態但又想減少莢膜生成，在2016年 The Journal of Crainiofacial Surgery有一篇Dr Man Koon Suh 的論文指出，可以利用異體真皮(ADM）覆蓋在矽膠表面，降低莢膜的厚度。這是愛美朋友可以參考的一些建議。
（本文參考出處為）
1. 2020 鄭東學院長：鼻整形
2. Gross and Pathologic Analysis of Long-Term Silicone Implants Inserted into the Human Body for Augmentation Rhinoplasty: 221 Revision Cases
3. The Journal of Crainiofacial Surgery: Augmentation Rhinoplasty With Silicone Implant-2016_silicone_implant ADM JCFS
#beauty #cosmetic #asthetic #plasticsurgery #cosmeticsurgery #nose #silicone
#nosejob #rhinoplasty #nosejobbeforeandafter #rhinoplastybeforeandafter #rhinoplastyspecialist #siliconimplant #calcification #美容 #整形 #鼻整形 #隆鼻 #鼻修復 #矽膠假體 #醫美 #台北 #東區 #博恩妍診所 #異體真皮隆鼻 #異體真皮貴族手術 #異體真皮粉 #no1nosetaipei
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