닫기

Ex) Article Title, Author, Keywords

Original Article

Split Viewer

J Cosmet Med 2017; 1(2): 106-111

Published online December 31, 2017

https://doi.org/10.25056/JCM.2017.1.2.106

A new classification system of nasal contractures

Geunuck Chang1, Donghak Jung2

1Hanabi Rhinoplasty Clinic, Seoul, Rep. of Korea, 2Shimmian Rhinoplasty Clinic, Seoul, Rep. of Korea

Correspondence to :
Geunuck Chang, Hanabi Rhinoplasty Clinic, 9F, 468 Gangnamdae-ro, Gangnam-gu, Seoul 48954, Rep. of Korea
Tel: 82-2-569-1161, Fax: 82-2-569-9806, E-mail: nicenose@naver.com

Received: January 20, 2017; Revised: September 20, 2017; Accepted: September 22, 2017

© Korean Society of Korean Cosmetic Surgery

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: The nasal contracture is one of the most severe complications that follow rhinoplasty. The proposed reasons for this complication are a capsular contraction from the silicone implant, pressure necrosis of the lower lateral cartilage due to the long nasal implant, and inflammation after alloplastic implantation. The severity and extent of nasal contracture vary depending on the cause and duration. Treatment of nasal contractures is very challenging and different from normal rhinoplasty procedures. To the best of our knowledge, an established classification has yet to be introduced for effective treatment.
Objective: To introduce a system for the classification of nasal contractures, for effective treatment decision-making.
Methods: Data from 245 nasal contractures were reviewed retrospectively. Pre-operatively, a complete rhinological examination including photographs was performed and a prior surgical history was taken. Two hundred forty-five patients had surgical treatments with various procedures. The authors classified the 245 cases according to severity and analyzed the patients’ data, including previous implants, infection history, and surgical procedures.
Results: Nasal contractures were classified into 6 categories. Type II (symmetric type, 42.4%) and Type III (asymmetric type, 33.5%) were the most common. A previous silicone implant was found in 77% of all cases of nasal contractures. A previous infection occurred in 56% of the cases. Extended spreader graft and strut graft were used for surgical treatment in 87% of the cases.
Conclusion: The authors have presented a new classification system of nasal contractures. Histories of a previous infection and previous silicone implant could be relevant parameters, however, it is not clear if they are direct causative factors. There was no significant correlation between the surgical management and type of nasal contracture.
Level of evidence: 3

Keywords: rhinoplasty, nasal contracture, classification, extended spreader graft, strut graft, alar retraction

  1. Deva AK, Merten S, Chang L. Silicone in nasal augmentation rhinoplasty: a decade of clinical experience. Plast Reconstr Surg 1998;102:1230-7.
    Pubmed CrossRef
  2. Jung DH, Moon HJ, Choi SH, Lam SM. Secondary rhinoplasty of the Asian nose: correction of the contracted nose. Aesthetic Plast Surg 2004;28:1-7.
    Pubmed CrossRef
  3. Jung DH, Medikeri GS, Chang GU, Hyun SM. Surgical techniques for the correction of postrhinoplasty depressed scars on the nasal tip. JAMA Facial Plast Surg 2015;17:405-12.
    Pubmed CrossRef
  4. Jung DH, Loh I. The “X-graft” for nasal tip surgery. Plast Reconstr Surg 2011;128:79e-80e.
    Pubmed CrossRef
  5. Jung DH, Tan KS, Jin SG. Nasal tip surgery: nasal lengthening and augmentation in Asian rhinoplasty. J Cosmet Med 2017;1:8-15.
    CrossRef
  6. Jung DH, Kwak ES, Kim HS. Correction of severe alar retraction with use of a cutaneous alar rotation flap. Plast Reconstr Surg 2009;123:1088-95.
    Pubmed CrossRef

Article

Original Article

J Cosmet Med 2017; 1(2): 106-111

Published online December 31, 2017 https://doi.org/10.25056/JCM.2017.1.2.106

Copyright © Korean Society of Korean Cosmetic Surgery.

A new classification system of nasal contractures

Geunuck Chang1, Donghak Jung2

1Hanabi Rhinoplasty Clinic, Seoul, Rep. of Korea, 2Shimmian Rhinoplasty Clinic, Seoul, Rep. of Korea

Correspondence to:Geunuck Chang, Hanabi Rhinoplasty Clinic, 9F, 468 Gangnamdae-ro, Gangnam-gu, Seoul 48954, Rep. of Korea
Tel: 82-2-569-1161, Fax: 82-2-569-9806, E-mail: nicenose@naver.com

Received: January 20, 2017; Revised: September 20, 2017; Accepted: September 22, 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The nasal contracture is one of the most severe complications that follow rhinoplasty. The proposed reasons for this complication are a capsular contraction from the silicone implant, pressure necrosis of the lower lateral cartilage due to the long nasal implant, and inflammation after alloplastic implantation. The severity and extent of nasal contracture vary depending on the cause and duration. Treatment of nasal contractures is very challenging and different from normal rhinoplasty procedures. To the best of our knowledge, an established classification has yet to be introduced for effective treatment.
Objective: To introduce a system for the classification of nasal contractures, for effective treatment decision-making.
Methods: Data from 245 nasal contractures were reviewed retrospectively. Pre-operatively, a complete rhinological examination including photographs was performed and a prior surgical history was taken. Two hundred forty-five patients had surgical treatments with various procedures. The authors classified the 245 cases according to severity and analyzed the patients’ data, including previous implants, infection history, and surgical procedures.
Results: Nasal contractures were classified into 6 categories. Type II (symmetric type, 42.4%) and Type III (asymmetric type, 33.5%) were the most common. A previous silicone implant was found in 77% of all cases of nasal contractures. A previous infection occurred in 56% of the cases. Extended spreader graft and strut graft were used for surgical treatment in 87% of the cases.
Conclusion: The authors have presented a new classification system of nasal contractures. Histories of a previous infection and previous silicone implant could be relevant parameters, however, it is not clear if they are direct causative factors. There was no significant correlation between the surgical management and type of nasal contracture.
Level of evidence: 3

Keywords: rhinoplasty, nasal contracture, classification, extended spreader graft, strut graft, alar retraction

References

  1. Deva AK, Merten S, Chang L. Silicone in nasal augmentation rhinoplasty: a decade of clinical experience. Plast Reconstr Surg 1998;102:1230-7.
    Pubmed CrossRef
  2. Jung DH, Moon HJ, Choi SH, Lam SM. Secondary rhinoplasty of the Asian nose: correction of the contracted nose. Aesthetic Plast Surg 2004;28:1-7.
    Pubmed CrossRef
  3. Jung DH, Medikeri GS, Chang GU, Hyun SM. Surgical techniques for the correction of postrhinoplasty depressed scars on the nasal tip. JAMA Facial Plast Surg 2015;17:405-12.
    Pubmed CrossRef
  4. Jung DH, Loh I. The “X-graft” for nasal tip surgery. Plast Reconstr Surg 2011;128:79e-80e.
    Pubmed CrossRef
  5. Jung DH, Tan KS, Jin SG. Nasal tip surgery: nasal lengthening and augmentation in Asian rhinoplasty. J Cosmet Med 2017;1:8-15.
    CrossRef
  6. Jung DH, Kwak ES, Kim HS. Correction of severe alar retraction with use of a cutaneous alar rotation flap. Plast Reconstr Surg 2009;123:1088-95.
    Pubmed CrossRef

Stats or Metrics

Share this article on :

  • line
  • mail

Related articles in JCM

Most KeyWord ?

What is Most Keyword?

  • It is most registrated keyword in articles at this journal during for 2 years.

Journal of Cosmetic Medicine

eISSN 2586-0585
pISSN 2508-8831
qr-code Download