Surgical Techniques for the Correction of Postrhinoplasty Depressed Scars on the Nasal Tip

Jung, Dong Hak; Medikeri, Gaurav; Chang, Guen-Uck; Hyun, Sang Min

doi:10.1001/jamafacial.2015.0911

Cited by 7 publications

(3 citation statements)

References 9 publications

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“…If there is no damage to the epidermis, soft tissue or cartilage can be used to correct it from the underside of the skin (camouflage technique). If there is an accompanying deformity of the epidermis, it is often nec essary to perform a correction using flap surgery [3].…”

Section: Discussionmentioning

confidence: 99%

A new classification system of nasal contractures

Chang¹,

Jung²

2017

J Cosmet Med

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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

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Section: Discussionmentioning

confidence: 99%

A new classification system of nasal contractures

Chang¹,

Jung²

2017

J Cosmet Med

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“…Additionally, the presence of facial scars may profoundly affect the daily routines and psychosocial well-being of patients [1][2][3]. Despite the advancements of surgical techniques, radiation, laser, and pressure therapy to treat facial scars, the outcomes are largely unsatisfactory [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy and Safety of Botulinum Toxin Type A Injections in Improving Facial Scars: A Systematic Review and Meta-Analysis

Wang

Liu

2022

Pharmacology

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Background: Botulinum toxin type A (BTA) has a wide range of clinical applications, and its use in improving aesthetics is one of them. The aim of this study was to better assess the efficacy and safety of BTA in patients with facial scars. Summary: We extracted the data of the visual analog scale (VAS) score, Vancouver scar scale (VSS) score, scar width, observer scar assessment scale (OSAS), patient scar assessment scale (PSAS), and/or drug-related adverse events. Five studies provided the data of VAS score, and the results showed that the VAS score in the BTA group was significantly higher than that in the control group. Three randomized controlled trials (RCTs) reported the VSS score. A statistically significant difference exists between the BTA group and the control group. Three RCTs reported the scar width after BTA treatment. A more favorable change was found in the BTA group with scar width even without statistical significance. Data about the OSAS and PSAS scores were available in two trials. There was no significant difference in OSAS and PSAS scores between the BTA group and the control group. Only three studies recorded three slight adverse events. There were no reports of severe complications. In conclusions, this study demonstrated that BTA has the potential to improve facial scars with an acceptable safety profile.

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“…Fibroblasts (Fbs) are present in the dermal layer of the skin and are the primary dermal cells to produce collagen and other extracellular matrix (ECM) components, and their normal proliferation and differentiation maintain the structure and physiological function of the skin ( 1 , 2 ). Depressed scars are characterized by a change in the structure of the dermal skin layer, as well as a reduced number of Fbs ( 3 , 4 ). Surgery, trauma, infections or other causes can make defects in the dermis layer of the skin and subcutaneous tissues, and to deplete the ECM forming a permanent depressed scar ( 5 – 7 ).…”

Section: Introductionmentioning

confidence: 99%

Role of rat autologous skin fibroblasts and mechanism underlying the repair of depressed scars

Zhao

Liu

Shi

et al. 2016

Experimental and Therapeutic Medicine

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The aim of the present study was to provide reliable experimental evidence for the application of autologous skin fibroblasts (asFbs) in the repair of depressed scars. In the experiments, depressed trauma was induced in male Wistar rats, and fibroblasts were separated from the removed skin tissues to culture in medium. In vitro cultured asFbs were injected into the depressed scar sites of rats, and the repair function of asFbs in the depressed scars was then examined at the cellular and whole-animal levels. The expression levels of type I and type III collagen in the dermal layer of the skin injected with asFb cells were significantly higher, as compared with those of the control, and type I collagen expression was significantly higher compared with Type III. Re-injection of asFbs into the dermal layer of depressed scars can markedly improve their repair. These results may prove useful for skin repair in clinical settings.

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Surgical Techniques for the Correction of Postrhinoplasty Depressed Scars on the Nasal Tip

Cited by 7 publications

References 9 publications

A new classification system of nasal contractures

A new classification system of nasal contractures

The Efficacy and Safety of Botulinum Toxin Type A Injections in Improving Facial Scars: A Systematic Review and Meta-Analysis

Role of rat autologous skin fibroblasts and mechanism underlying the repair of depressed scars

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