Applied Anatomic Study And Clinical Application In The Plastic Surgery Of The Nasal Tip Of SMAS Tissue Coverage

BACKGROUND: Over the past 20 years the domestic plastic cosmetic surgery have boomed and reached a certain high level. People are no longer satisfied with the general and rough improvement of the face and scan the effect of surgery in a more exacting way. People pursuit a more perfect face personality,at the same time propose a higher demand for clinical workers. With the the rise of open rhinoplasty, many new techniques will use "nasal subunit" and other fine anatomical concept to obtain a satisfactory aesthetic effect. Solid silicone rubber is still the major clinical applied materials in rhinoplasty. Regardless of the type of prosthesis materials there are various complications, in particular, are the most common prosthesis exposed. For prosthesis exposing from the tip, a number of academics have taken a number of ways to avoid such complications. More mature approach is the application of ear cartilage united with silicone prosthesis implantation method, this method can increase the thickness of the nasal tip organizations to avoid prosthesis expose from the tip of the nose prominent, but also allows the natural shape tip. Some scholars take dermal filling tip site, the use of leather covering prostheses, partial buffer stress,also achieved good results. Although these methods have achieved good effect, especially for skin meager tip, but it is necessary to incise tissue parts from the nose.OBJECTIVE: Study of the soft tissue of the nose make clear the scope and their specific relationship with surrounding tissue,its tissue components, at the same time applying in the plastic surgery of the nasal tip, explore a new surgical methods to prevent exposure of prosthesis from the tip.METHODS: Divided into two parts, Part I: Choose head of adult bodies fixed with 10% formaldehyde solution, irritated in red latex through the radial artery and femoral artery, of six man,three woman. With naked eye dissect the body of anatomical specimens, marke anatomical range with marker pen , from the nasion downward along the nose to nose on both sides of the lateral, along the nasal dorsum incision designed median line, the application of sophisticated orthopedic surgical instruments, stratified on nasal anatomy, observed and photographed. Analog clinical surgical approach, folded soft tissue so that it fully located at the nose tip, observe the outcome. Cut nasal soft tissue and nasal dorsum fascia, were embedded in paraffin, sliced, HE staining to observe the morphology. Part II: Applicate the nasal soft tissue in rhinoplasty and cosmetic and plastic surgery, observing the effect of surgery.RESULTS: Nose autopsy found that nasal soft tissue is not a new found organizational structure, but a special definition of nasal dorsum SMAS layer in order to facilitate the performance of cosmetic surgery and mutual exchange of practical of its range including the SMAS of lower lateral cartilages (alar cartilages) and part nasal lateral artilages. At the same time, analog cosmetic plastic surgery on the body nose cutting soft tissue methods and specific applications can proved that at the surface of cartilage separation and mobilization nasal soft tissue are feasible, folded after the tip placed to increase the thickness of the nasal tip. Clinicaln nasal surgery prove the clinical application of nasal soft tissue reduce the complications of rhinoplasty in the prosthesis exposed from the tip,at the same time the tip are more natural.CONCLUSION: Nasal soft tissue will be used in cosmetic and plastic surgery of the nasal tip. The produce make it difficult for prosthesis to exposure from the nasal tip,and tip will be more narural. This surgical methods should be promoted.