8/14/2019 Augmented Asian Rhinoplasty(Green Background)

1/19

Augmented Asian RhinoplastyAugmented Asian Rhinoplasty

The Art and The ScienceThe Art and The Science

Past, Present andPast, Present andFutureFuture

ThaneeThanee

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

2/19

Characteristics of AsianCharacteristics of Asian

nosenose Wash out dorsum or saddle deformityWash out dorsum or saddle deformity

Deficient tip projectionDeficient tip projection

Wide lobule, thick lobular skinWide lobule, thick lobular skin Abundant subcutaneous fatty tissueAbundant subcutaneous fatty tissue

Alar flaringAlar flaring

Retracted columellaRetracted columella

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

3/19

Asian saddle noseAsian saddle nose

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

4/19

Asian Rhinoplasty requiresAsian Rhinoplasty requires

Augmentation of dorsum areaAugmentation of dorsum area

Augmentation on top of lateral cartilage areaAugmentation on top of lateral cartilage area

Augmentation of columella-tip area for tipAugmentation of columella-tip area for tipprojection and increase nasal lengthprojection and increase nasal length

Refining the lobule/tip areaRefining the lobule/tip area

Decrease the width of the nostrilsDecrease the width of the nostrils

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

5/19

Augmentation AsianAugmentation Asian

RhinoplastyRhinoplasty

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

6/19

In theIn the oldold day of Asian rhinoplastyday of Asian rhinoplasty Injected liquid paraffin orInjected liquid paraffin or

liquid siliconeliquid silicone

L-shaped alloplasticL-shaped alloplastic

implant, mainlyimplant, mainly

silicone elastomer.silicone elastomer.

Rib autograft or homograft.Rib autograft or homograft.

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

7/19

To the Present timeTo the Present time Novel design siliconeNovel design silicone

implant with tip protectionimplant with tip protectionusing ear, septal or lowerusing ear, septal or lower

lateral cartilage.lateral cartilage.

Autogenous costal cartilageAutogenous costal cartilagegraft.graft.

Autogenous ear cartilage graftAutogenous ear cartilage graftin multiple layers(onlay graft).in multiple layers(onlay graft).

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

8/19

To the present timeTo the present time(continue)(continue)

Bioplastic.Bioplastic.

The weird technology:The weird technology:

hard silicone in solvent.hard silicone in solvent.

FabricatedFabricatedperichondrocartilageperichondrocartilagecomplexcomplex from bothfrom both

ears into auto-nasalears into auto-nasalbioprosthesis.bioprosthesis.

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

9/19

What is theWhat is the perichondrocartilage complexperichondrocartilage complex??

Cartilage with intactCartilage with intact

perichondrium.perichondrium.

In asian rhinoplasty, weIn asian rhinoplasty, we

harvest this complex fromharvest this complex from

both external ears.both external ears.

The complex will functionThe complex will function

as aas a living tissueliving tissue when it iswhen it is

implanted in human body.implanted in human body.

Harvest

DesignFabricate

Finish

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

10/19

From raw materials to finished bioprosthesisFrom raw materials to finished bioprosthesis

i h h bl f

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

11/19

Bioprostheses correct the problems ofBioprostheses correct the problems of

silicone prosthesis in Asian rhinoplastysilicone prosthesis in Asian rhinoplasty

InfectionInfection

ProtrusionProtrusion

PerforationPerforation

i h h dBi th t th d

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

12/19

Bioprostheses correct the dorsumBioprostheses correct the dorsum

injecton of liquid siliconeinjecton of liquid silicone

B tt

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

13/19

B oprost eses n m sce aneousoprost eses n m sce aneousconditionsconditions

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

14/19

Rhinoplasty

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

15/19

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

16/19

..

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

17/19

The future is comingThe future is coming

Regenerative medicine :Regenerative medicine :

In the future, tissue damages will be replace withIn the future, tissue damages will be replace with

tissue substitutes.tissue substitutes.

Tissue engineering:Tissue engineering:

Bioengineer and biomedical engineer make tissueBioengineer and biomedical engineer make tissue

substitutes as body parts and ready to use. No more donorsubstitutes as body parts and ready to use. No more donor

site morbidity and deformity at all.site morbidity and deformity at all.

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

18/19

In cartilage tissue engineer labIn cartilage tissue engineer lab

8/14/2019 Augmented Asian Rhinoplasty(Green Background)

19/19

ConclusionConclusion

Silicone elastomer and new inert biomaterials still have place inSilicone elastomer and new inert biomaterials still have place inasian rhinoplasty.asian rhinoplasty.

Autogenous cartilage fabrication in the form of nasal prosthesisAutogenous cartilage fabrication in the form of nasal prosthesiswill replace and use more and more.will replace and use more and more.

Cartilage tissue engineering in the form of nasalCartilage tissue engineering in the form of nasal

prostheses will be used in the future.prostheses will be used in the future.