前沿拓展：上海ldo整形 學(xué)費(fèi)多少

Management of the nasal dorsum remains a challenge in rhinoplasty surgery, with many reduction rhinoplasties resulting in destruction of the key-stone area. This may require reconstruction with either spreader grafts or spreader flaps, both for aesthetic and functional reasons. Dr Baris Cakir, internationally renowned for his conceptualization of the “polygon rhinoplasty” in tip surface aesthetics with co-author Dr Rollin Daniel advocates the use of dorsal preservation via an (1) endonasal approach (2) removal of a septal strip in the subdorsal area whose shape and height are determined preoperatively (3) complete lateral, transverse and radix osteotomies and (4) dorsal reduction, utilizing a let down operation (LDO) or a push down operation () (Figure 1).3,4 The LDO consists of a maxillary wedge resection and is performed in patients who need more than 4mm if lowering, whereas the consists of downward impaction of the fully mobilised nasal pyramid and is utilized in patients with smaller humps (<4mm). This technique of dorsal preservation results in more natural postoperative dorsum lines, with fewer dorsal irregularities, inverted-V deformities or need for midvault reconstruction in selected primary patients.4Furthermore, dissection is performed in a complete subperichondrial plane to minimise soft tissue disruption, resulting in less scar tissue formation and preservation of ligamentous structures.5Intra-operatively the scroll ligament and Pitanguy’s midline ligament are repaired to stabilize the internal valve and tip position, and long-term post operatively preserve tip definition and elasticity, respectively.

翻譯如下：

鼻背仍然是鼻成形術(shù)手術(shù)中的一個(gè)挑戰(zhàn)，許多減少的鼻整形導(dǎo)致了關(guān)鍵的結(jié)石區(qū)的破壞。這可能需要重建或擴(kuò)張器移植物或擴(kuò)張皮瓣，無(wú)論是美學(xué)和功能的原因。Baris Cakir博士，以他與合著者Rollin Daniel博士在表面美學(xué)中對(duì)“多邊形鼻成形術(shù)”的概念化而聞名，他提倡通過(guò)(1)鼻內(nèi)入路(2)切除在背下區(qū)的隔帶，其形狀和高度在術(shù)前確定(3)完全的側(cè)、橫、基骨性切開術(shù)和(4)背側(cè)復(fù)位，使用松馳手術(shù)(LDO)或向下推倒手術(shù)(圖1)。3，4 LDO由上頜骨楔形切除術(shù)組成，如果下降需要超過(guò)4mm，則行LDO手術(shù)，而是由完全活動(dòng)的鼻金字塔向下撞擊而成，用于較小的駝峰患者(<4mm)。這種背側(cè)保存技術(shù)使術(shù)后背線更加自然，在選定的原發(fā)患者中，背側(cè)不規(guī)則、倒置-V畸形或需要重建中穹窿的情況較少。

此外，在一個(gè)完整的軟骨下平面進(jìn)行解剖，以盡量減少軟組織破壞，減少疤痕組織形成和保留韌帶結(jié)構(gòu)。

拓展知識(shí)：上海ldo整形 學(xué)費(fèi)多少

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