For further reference, below July update of cases from Dr. Hsu who does 100% autologous implant.
For those who cannot read Chinese, photos on the left are silicon implant. You wld see at bottom of the page coloured silicon he removed and it showed shaping of the tip.
He mentioned that no matter whether insertion under skin (like in the past) or under periosteum, silicon implant will still shift - only a matter of degree becos cells of the nose are unable to grow on it (exactly the reason why goretex is deemed difficult to remove!)
QUOTE
目前一般矽膠人工鼻骨有所謂放皮下跟放骨膜下
早期都是放在皮下，但是那支矽膠棒子因為左右很容易滑動
現在提倡放在骨膜下，因為號稱比較不會左右滑動
但是其實放在骨膜下還是會滑動，只是左右位移的距離少很多
為何矽膠會滑動？
這是因為材質的問題
因為矽膠人體的細胞長不進去，只會形成一層膜把矽膠包起來
所以矽膠會跟那層膜之間可以有相對位移
其實就算放在骨膜下
仔細搖動去感覺
還是可以感覺得出來一些輕微的位移
UNQUOTE
http://mypaper.pchome.com.tw/news/hsuyc ... centerFlag
+++
He further wrote:
矽膠雖然報告併發症的機率約10-15%, 但是事實上還有很多人
因為矽膠鼻會搖晃、不自然等因素而把人工鼻骨拿掉的，這也不在少數
有些剛隆完矽膠鼻看起來很滿意,時間久了之後矽膠的夾膜巒縮鼻子看起來就會不自然
所以說，一個手術的結果是要看長期自體手術當然也是有風險. 不過自體手術半年後沒有問題，之後出現問題的機會就少很多
但是矽膠手術的問題是隨著時間累積的時間越久，統計上發生問題的人越多
基本上手術應該要長期追蹤病人這才有辦法知道手術長期的結果是不是令人滿意
In context:
Initial infection/complication rate of silicon is 10-15%. However, in reality there are many who removed their silicon implants due to unnatural or crooked implants after some time.
Some who found that their implant look good initially often find problem as the silicon implants stay long and producing a layer of membrane between the bridge causing the nose to look unnatural over time.
Problems of silicon implants are accumulative over time. (thus the rate of removal is much higher.)
There are also complications with 100% autologous implants. However, problems do not typically extend beyond 6 months.
It is important to track the progress of patients over a longer period of time to observe if their implant produced satisfactory results.
http://mypaper.pchome.com.tw/news/hsuyc ... centerFlag
+++
Ah, below a little info on goretex.
In context:
I attend a Rhinoplasty conference in the Chicago, USA in 2005. Herewtih some info:
Early stage complications of silicon is 5.5%
Late stage complications abt 4.3%
Overall, a stats of 9.8% over 10 years after op.
Altho, Goretex as a new source of implant can merged with nose's cells. The infection rate is 3.2% and more importantly, it is difficult to remove causing higher cost/time.
Docs who use silicons are generally reluctant to spend time for Rhino op. they rely on fixed molds and use little shaping. Taking only 30-50 mins to fit in the 'mould'. There are of course exceptions.
2005年到美國芝加哥參加了一場鼻整型的研討會一些資訊提出來跟大家分享之前我有一篇文章提到軟骨與矽膠的差異
美國的報告矽膠在鼻整型的早期併發症比率為5.5%
晚期併發症比率為4.3%
整體10年來說為9.8%
新的材質Gore-tex雖然有可以與人體結合等優點（矽膠不行，會形成一層夾膜）
但是感染率美國的報告也有3.2％ 而且重點是如果感染後會因為細胞跟Gore-tex長在一起會很難移除，所以醫師要移除之前的Gore-tex要多收費（因為要多花一個小時）
故美國幾位鼻整型的大師都是以自體的軟骨作為移植材料的首選。矽膠隆鼻在亞洲及東南亞一帶比較風行
對於一位基本的整型外科醫師來說矽膠隆鼻只是2-3萬，30-50分鐘的小手術
很少有醫師願意花時間在學習鼻整型上面所以做出來的鼻型只會造著矽膠模子跑，鼻型比較沒特色。當然國內也有一些比較專精的整型科醫師會以軟骨做鼻整型手術的。
http://mypaper.pchome.com.tw/news/hsuyc ... centerFlag
) she speaks good english and shared her experience of silicon incl. 3 times silicon by various docs in korea and then last by Dr. Jung with goretex. the reason she concdeded to remove her impant and juz lived without one is cos she simply has too many complications after silicon implants to her sensitive nose. goretex only works in her case for 6 yrs and she began to develop serious sinus and later infection.
