Genuine leather (dermal graft) Using genuine leather to augment the nose. It is surgery to remove skin from one area of the body. by cutting the leather into the shape of a rugby ball and then sewing close the wound in a straight line.
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The most popular location for dermis removal is the intercostal slit near the coccyx. because it is thicker than other areas And the scar can hide well in the butt slit. The resulting skin, the surgery will cut off the upper epidermis. Then bring only the lower dermis to perform different areas of the nose as desired by the dermis. suitable for augmenting the tip of the nose in people with thin nose skin to increase the thickness of the nose There are reports of using dermis for nose bridge augmentation. This may increase the nose bridge by 2-3 millimeters.
Dermal fat graft is the removal of tissue similar to dermal graft. The difference is that the surgeon will remove the deep fat that Comes with real leather to increase tissue thickness This method is currently less popular. because the attached fat has a very high atrophy It doesn’t have a satisfactory shape in the long run.
membrane and the muscle membranes (periosteum and fascia) are used in two main cases.
The first method is to cover the silicone tip. to prevent penetration of the silicone But this method doesn’t have much evidence of its benefit. And there are always reports of penetration of silicone. even though it is covered with muscle membranes The second method is to be wrapped in chopped cartilage to prevent shedding of the cartilage to go where it is not needed This method is effective in patients with thin nose skin. But in people who use thick nose skin will make it look thicker and bulkier until it is unnatural except for the patient’s own tissue There are also tissues from donor cadavers (human cadaveric tissue), which are usually will not be able to easily take tissues from other people because each person’s body will create a reaction against other cells cause a severe inflammatory reaction However, there are also tissues from other individuals that may be used: human cadaveric cartilage Because cartilage is a specialized tissue with low cell distribution, resistance from the body is encountered. relatively few compared to other tissue types, however, it has been reported Nose surgery from donated cartilage There is unpredictable corrosion and decomposition in the long run. And after treatment for more than 4 years, it will result in a deformed nose shape, unlike what the surgeon did in the first place. for this reason thus making this method not yet popular
Human cadaveric dermis is the scientific process of removing the dermis layer from a donor cadaver, which removes all of the cells present in the skin. will make the dermis skin retain its structure which is free of cells only This method is medically called ADM or acellular dermal matrix, or as people often call it. artificial leather
Animal tissue Transplantation of tissue from different species into the human body produces a stronger reaction than that. A lot of different human tissues are used. At present, tissues from some animals are taken. Through the process of cell elimination and made into artificial leather or ADM, which is the only case where animal tissue can be safely used in humans.
However, artificial leather or ADM, whether made from humans or animals, is no different from genuine leather. with soft properties Therefore, it is not suitable for structural surgery such as the bridge of the nose, but it is suitable for augmenting the nose tip. For those who have a problem with thin nose tip because of wearing silicone for a long time, etc. Another disadvantage of ADM is the high price, which is quite an obstacle for rhinoplasty surgery.
Synthetic material (alloplastic material)
It is a synthetic material from the factory. and must be of a proven type then its standard Can be used in the patient The advantages of synthetic materials are that they are easy to find, inexpensive, and save time for surgery. You don’t have to hurt yourself in many places. In order to dissect the tissue itself, the disadvantage of synthetic materials is there is a chance of infection Because if there is a germ to stick to synthetic materials it often causes severe infections. It is often not curable with antibiotics. Therefore often end up with By removing the synthetic material, the infection can be successfully eliminated and because it is a foreign substance to the body. When inserted the body will create a fascia is a capsule to cover These membranes have contractile properties. cause sometimes Shrinks the synthetic materials that are surgically inserted. Until resulting in a deformed nose. In addition, if the synthetic material is worn for a long time, there is a continuous force between the synthetic material and the nose. Especially in cases with short noses and using silicone or other synthetic materials to push the nose longer over time Tissues that are constantly coated with synthetic materials become thinner (tip of the nose or inner nasal cavity tissue), allowing the silicone or synthetic rods to be seen. If left for a long time, it may cause the synthetic material to penetrate the surface.