Scarpa씨 근막을 이용한 이차 비성형술

Secondary Rhinoplasty Using Scarpa's Fascia

  • 오광진 (전북대학교 의학전문대학원 성형외과학교실) ;
  • 김종진 (전북대학교 의학전문대학원 성형외과학교실) ;
  • 이내호 (전북대학교 의학전문대학원 성형외과학교실) ;
  • 양경무 (전북대학교 의학전문대학원 성형외과학교실)
  • Oh, Gwang Jin (Department of Plastic and Reconstructive Surgery, Medical School, Chonbuk National University) ;
  • Kim, Jong Jin (Department of Plastic and Reconstructive Surgery, Medical School, Chonbuk National University, Jeonju, Korea) ;
  • Lee, Nae Ho (Department of Plastic and Reconstructive Surgery, Medical School, Chonbuk National University) ;
  • Yang, Kyung Moo (Department of Plastic and Reconstructive Surgery, Medical School, Chonbuk National University)
  • 투고 : 2007.10.09
  • 발행 : 2008.01.10

초록

Purpose: The performance of rhinoplasty on the patient who has already undergone unsatisfactory results or complications after augmentation rhinoplasty is a challenging surgical problem. Because the dead space is remained after removal of the foreign body and the thickness of the skin is not even, the deformity would be more conspicuous if the nose is reconstructed again with hard implant only or autogenous cartilage. In these cases, the autogenous fascia can be used to get a good result. We present our clinical experience of secondary rhinoplasty using Scarpa's fascia of lower abdomen. Methods: Thirty-two patients underwent the procedure from March of 2002 to February of 2007. Nine patients were reconstructed with Scarpa's fascia only, eighteen patients were reconstructed with silicone implant and fascia, and five patients were reconstructed with cartilage and fascia for secondary rhinoplasty. Results: There were no major complications. Most of the patients were satisfied with the results. The deviation of the silicone implant and postoperative hypertrophic scar of the donor site were seen in one case each. Postoperative absorption of fascia were seen in two cases using Scarpa's fascia only. Conclusion: Secondary rhinoplasty using Scarpa's fascia is very useful method which offers a minimized donor site scar, low complication rate, shorter operation time and patient satisfaction and prevents the alopecia caused by the harvest of temporalis fascia.

키워드

참고문헌

  1. Lee PK, Kim YJ, Wee SS, Cho MJ: Treatment of the complications after augmentation rhinoplasty: Dermofat gaft. J Korean Soc Plast Reconstr Surg 18: 697, 1991
  2. Chung SM, Kim HO, Jung SH, Kim SS: Correction of nasal deformity using conchal cartilage. J Korean Soc Plast Reconstr Surg 19: 638, 1992
  3. Han KH, Park DM, Song JW, Kang JS: Nasal tip projection with autogenous cartilage grafts. J Korean Soc Plast Reconstr Surg 17: 632, 1990
  4. Elahi MM, Jackson IT, Moreira-Gonzalez A, Yamini D: Nasal augmentation with Surgicel-wrapped diced cartilage: a review of 67 consecutive cases. Plast Reconstr Surg 111: 1309, 2003 https://doi.org/10.1097/01.PRS.0000047442.41691.C8
  5. Yoon CG, Park CS, Cho DW, Ham KS: A clinical study on the mechanism of the curved deformity of implanted nasal prothesis. J Korean Soc Plast Reconstr Surg 15: 65, 1988
  6. Kim ES: A clinical experience with the use of Gore- Tex implant in augmentation rhinoplasty. J Korean Soc Plast Reconstr Surg 31: 34, 2004
  7. Gryskiewicz JM, Rohrich, RJ, Reagan BJ: The use of AlloDerm for the correction of nasal contour deformities. Plast Reconstr Surg 107: 561, 2001 https://doi.org/10.1097/00006534-200102000-00040
  8. Guerrerosantos J: Temporoparietal free fascia grafts in rhinoplasty. Plast Reconstr Surg 74: 465, 1984 https://doi.org/10.1097/00006534-198410000-00001
  9. Brenner KA, McConnell MP, Evans GR, Calvert JW: Survival of diced cartilage grafts: an experimental study. Plast Reconstr Surg 117: 105, 2006 https://doi.org/10.1097/01.prs.0000195082.38311.f4
  10. Baek HJ, Shim YK, Kim YS, Lee SI: Clinical application of the superficial temporal fascial flap. J Korean Soc Plast Reconstr Surg 15: 543, 1988
  11. Tobin CE, Benjamin JA: Anatomical study and clinical consideration of the fasciae limiting urinary extravasation from the penile urethra. Surg Gynecol Obstet 79: 195, 1944
  12. Lockwood TE: Lower body lift with superficial fascial system suspension. Plast Reconstr Surg 92: 1112, 1993 https://doi.org/10.1097/00006534-199311000-00018
  13. Lockwood TE: Superficial fascial system(SFS) of the trunk and extremities: a new concept. Plast Reconstr Surg 87: 1009, 1991 https://doi.org/10.1097/00006534-199106000-00001