There is some info which some experts said:
A simple technique of removing the excessive muscle and softening or eliminating the epicanthal fold of the Asian upper eyelid without creating incisions in the medial canthal region, thus avoiding these complications.
Surgical technique:
Instead of creating complicated transposition flaps and unsightly incisions, we perform a subcutaneous epicanthoplasty in conjunction with upper eyelid blepharoplasty or ptosis repair. The upper eyelid crease incision and the epicanthal fold are marked prior to infiltration with local anesthetic. The incision should not extend into the medial canthal region or over the crest of the epicanthal fold.
Upper eyelid blepharoplasty or aponeurotic ptosis surgery is performed in the usual manner. Excision of the underlying musculature from the epicanthal fold begins at the medial end of the eyelid crease incision (Figure 1). Tension on the medial aspect of the incision in the direction of the epicanthal fold demonstrates the hypertrophic orbicularis muscle underlying and creating the epicanthal fold.
The skin of the epicanthal fold is elevated with skin hooks, and the orbicularis muscle is dissected away from the overlying skin (Figure 2). During the dissection and excision of the orbicularis muscle, the angular or infratrochlear vessels may be encountered, and meticulous cautery is essential to maintain hemostasis. Direct cauterization of the skin must be applied cautiously to prevent scarring.
The extent of the dissection and excision of the underlying hypertrophic orbicularis muscle should be graded depending on how much the epicanthal fold is to be softened. If complete elimination of the epicanthal fold is desired, deep tissue fixation at the medial edge of the blepharoplasty incision is accomplished by anchoring the skin to the deep tissues with a strong absorbable suture, such as 6-0 chromic catgut (Figure 3). One or two interrupted sutures are usually sufficient to provide adequate deep fixation and further eliminate the epicanthal fold and prevent its recurrence. The eyelid crease incision is then closed in the usual manner. Antibiotic/steroid ointment is applied to the incision, and the patient is instructed in routine postoperative wound care.
By aggressively removing the musculature underlying the epicanthal fold, with the "No Scar Asian Epicanthoplasty" the surgeon is able to avoid the use of complicated and unsightly transposition flaps. There is minimal risk of web formation or scar formation in the medial canthal region since no skin incisions are made in that area.
This technique does not create unnatural lines, folds, or scars, and it is simple to perform in conjunction with upper eyelid blepharoplasty or ptosis repair. An added benefit of this technique is that it can be graded either to soften or to eliminate the epicanthal folds depending on the amount of musculature removed.
In our experience, most Asian patients do not wish to eliminate their epicanthal folds completely and have the occidental eyelid appearance. Their expectations are to have a less noticeable epicanthal fold after creation of an upper eyelid crease rather than a more prominent epicanthal fold as occurs if nothing is done to soften the fold. This creates the cosmetically desirable "Euro-Asiatic" eyelid rather than an occidental eyelid. In summary, softening of the epicanthal fold is necessary when creating an upper eyelid crease in the Asian patient. We believe that the cosmetic correction of most Asian epicanthal folds can be performed without the use of confusing and complicated transposition flaps. Our technique is a simple, graded procedure that can be performed in conjunction with upper eyelid blepharoplasty or ptosis repair.
Reference
* Yen MT, Jordan DR, Anderson RL. No-scar Asian epicanthoplasty: a subcutaneous approach. Ophthal Plast Reconstr Surg 2002;18:40-44.
Michael T. Yen, MD, is assistant professor of ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX.
David R. Jordan, MD, is professor of ophthalmology, University of Ottawa, Ontario, Canada. Richard L. Anderson, MD, editor of Plastics Pearls, is an ophthalmic and facial plastic surgeon. He is medical director of Center for Facial Appearances, Salt Lake City, UT
Wednesday, October 3, 2007
Epicanthoplasty with Modified “Y-V”
Epicanthoplasty with Modified “Y-V” Advancement Procedure Abstract The presence of epicanthal folds and lack of supratarsal folds are unique features in most of Asian eyelids.
There are many surgical procedures designed to eliminate epicanthal folds. However, scarring on medial canthus is the main obstacle for surgeons to overcome. From 1989-1 to 1997-11, we used modified “Y-V” advancement procedures to correct epicanthal folds in Asian eyelids in 148 cases.
Five cases of them are congenital palpebral anomalies including congenital entropion, congenital ptosis and Down syndrome. Neither lacrimal apparatus injury nor asymmetry of the eyes was noted.
One case received revision surgery because of resultant unnatural supratarsal fold.
One case received intralesional injection of triamcinolone six months after operation for epicanthal hypertrophic scar.
We thought that the modified “Y-V” advancement procedure could make least scarring on medial canthus in correcting Oriental epicanthal folds and congenital palpebral anomalies. It can be also combined with blepharoplasties and corrective procedures of eyelids simultaneously.
Introduction Creation of a supratarsal fold is the most frequent procedure performed in cosmetic surgery in Orientals.
However, the presence of epicanthal fold weakens the surgical result. Many surgeons persuaded patients to accept their presence in order not to risk the scarring on medial canthus by epicanthoplasty.
Ree and Wood-Smith1 reported that operations to correct the epicanthal fold can be fraught with problems and may result in unsightly scarring of the eyelids.
Park2 classified medial canthus into four types (Fig. 1). Most of the Oriental eyelids with a supratarasal fold fall into type III.
Fernandez3 summarized that 50% of all Orientals lacked a supratarsal fold. Though the incidence of epicanthal fold is not known, we found most of Orientals has an epicanthal fold of varying prominence whether a supratarsal fold is present or not.
Many methods had been mentioned to correct congenital epicanthus in literature.
Some of them are too extensive to correct the Asian epicanthal folds and result in unsightly scar. Several techniques unique for Asian epicanthal folds had been designed. The late Dr. Junichi Uchida14 introduced his spilt V-W plasty in 1962, which is still popular in epicanthoplasty in Oriental eyes.
Flowers15 modified Uchida’s technique and Matsunaga16 used a modified “M”plasty to correct the epicanthal folds.
Fuente17 created a transposition flap whose base, in the medial canthal region, is taken from the posterior surface of the epicanthal fold.
Jordan18 did not remove skin over the epicanthal fold. He removed excessive underlying muscle beneath the fold and attaching the skin edges with “a deep tissue approach” .
Yoon19 modified the Mustard’e technique as so called “one-armed jumping man incision” . Wu20 used the idea of square-flap method21 to correct the epicanthal folds.
Park2 used Z-epicanthoplasty, which was similar to the way Fuente introduced. Materials and Methods From 1989-1 to 1997-11, we had performed the extended Y-V epicanthoplasty in one hundred and forty eight cases. The age ranged from 4 years to 59 years, averaged 27.3 years. (Table I) The follow-up period was ranged from one month to 7 years.
The indications of extended Y-V epicanthoplasty are presence of epicanthal web and 1) widened distance between the eyes (greater than 3.5 cm); 2) congenital ptosis; 3) congenital entropion; 4) telecanthus.
Among the 148 cases, 143 cases received the procedure for correcting Oriental epicanthal folds and 5 of them, for congenital palpebral anomalies. 12 cases received extended Y-V epicanthoplasty alone.
In the other 135 cases, other aesthetic procedures were combined with extended Y-V epicanthoplasty. The detailed data was shown on Table II.
Epicanthoplasty with Modified “Y-V” Advancement Procedure Abstract The presence of epicanthal folds and lack of supratarsal folds are unique features in most of Asian eyelids. There are many surgical procedures designed to eliminate epicanthal folds.
However, scarring on medial canthus is the main obstacle for surgeons to overcome. From 1989-1 to 1997-11, we used modified “Y-V” advancement procedures to correct epicanthal folds in Asian eyelids in 148 cases.
Five cases of them are congenital palpebral anomalies including congenital entropion, congenital ptosis and Down syndrome.
Neither lacrimal apparatus injury nor asymmetry of the eyes was noted. One case received revision surgery because of resultant unnatural supratarsal fold.
One case received intralesional injection of triamcinolone six months after operation for epicanthal hypertrophic scar.
We thought that the modified “Y-V” advancement procedure could make least scarring on medial canthus in correcting Oriental epicanthal folds and congenital palpebral anomalies. It can be also combined with blepharoplasties and corrective procedures of eyelids simultaneously. Introduction Creation of a supratarsal fold is the most frequent procedure performed in cosmetic surgery in Orientals. However, the presence of epicanthal fold weakens the surgical result.
Many surgeons persuaded patients to accept their presence in order not to risk the scarring on medial canthus by epicanthoplasty.
Ree and Wood-Smith1 reported that operations to correct the epicanthal fold can be fraught with problems and may result in unsightly scarring of the eyelids. Park2 classified medial canthus into four types.
Most of the Oriental eyelids with a supratarasal fold fall into type III. Fernandez3 summarized that 50% of all Orientals lacked a supratarsal fold. Though the incidence of epicanthal fold is not known, we found most of Orientals has an epicanthal fold of varying prominence whether a supratarsal fold is present or not.
Many methods had been mentioned to correct congenital epicanthus in literature.4-13. Some of them are too extensive to correct the Asian epicanthal folds and result in unsightly scar. Several techniques unique for Asian epicanthal folds had been designed.
The late Dr. Junichi Uchida14 introduced his spilt V-W plasty in 1962, which is still popular in epicanthoplasty in Oriental eyes. Flowers15 modified Uchida’s technique and Matsunaga16 used a modified “M”plasty to correct the epicanthal folds.
Fuente17 created a transposition flap whose base, in the medial canthal region, is taken from the posterior surface of the epicanthal fold.
Jordan18 did not remove skin over the epicanthal fold. He removed excessive underlying muscle beneath the fold and attaching the skin edges with “a deep tissue approach”.
Yoon19 modified the Mustard’e technique as so called “one-armed jumping man incision”.
Wu20 used the idea of square-flap method21 to correct the epicanthal folds.
Park2 used Z-epicanthoplasty, which was similar to the way Fuente introduced. Materials and Methods From 1989-1 to 1997-11, we had performed the extended Y-V epicanthoplasty in one hundred and forty eight cases.
The age ranged from 4 years to 59 years, averaged 27.3 years.
The follow-up period was ranged from one month to 7 years. The indications of extended Y-V epicanthoplasty are presence of epicanthal web and
1) widened distance between the eyes (greater than 3.5 cm); 2) congenital ptosis; 3) congenital entropion; 4) telecanthus. Among the 148 cases, 143 cases received the procedure for correcting Oriental epicanthal folds and 5 of them, for congenital palpebral anomalies.
12 cases received extended Y-V epicanthoplasty alone. In the other 135 cases, other aesthetic procedures were combined with extended Y-V epicanthoplasty.
There are many surgical procedures designed to eliminate epicanthal folds. However, scarring on medial canthus is the main obstacle for surgeons to overcome. From 1989-1 to 1997-11, we used modified “Y-V” advancement procedures to correct epicanthal folds in Asian eyelids in 148 cases.
Five cases of them are congenital palpebral anomalies including congenital entropion, congenital ptosis and Down syndrome. Neither lacrimal apparatus injury nor asymmetry of the eyes was noted.
One case received revision surgery because of resultant unnatural supratarsal fold.
One case received intralesional injection of triamcinolone six months after operation for epicanthal hypertrophic scar.
We thought that the modified “Y-V” advancement procedure could make least scarring on medial canthus in correcting Oriental epicanthal folds and congenital palpebral anomalies. It can be also combined with blepharoplasties and corrective procedures of eyelids simultaneously.
Introduction Creation of a supratarsal fold is the most frequent procedure performed in cosmetic surgery in Orientals.
However, the presence of epicanthal fold weakens the surgical result. Many surgeons persuaded patients to accept their presence in order not to risk the scarring on medial canthus by epicanthoplasty.
Ree and Wood-Smith1 reported that operations to correct the epicanthal fold can be fraught with problems and may result in unsightly scarring of the eyelids.
Park2 classified medial canthus into four types (Fig. 1). Most of the Oriental eyelids with a supratarasal fold fall into type III.
Fernandez3 summarized that 50% of all Orientals lacked a supratarsal fold. Though the incidence of epicanthal fold is not known, we found most of Orientals has an epicanthal fold of varying prominence whether a supratarsal fold is present or not.
Many methods had been mentioned to correct congenital epicanthus in literature.
Some of them are too extensive to correct the Asian epicanthal folds and result in unsightly scar. Several techniques unique for Asian epicanthal folds had been designed. The late Dr. Junichi Uchida14 introduced his spilt V-W plasty in 1962, which is still popular in epicanthoplasty in Oriental eyes.
Flowers15 modified Uchida’s technique and Matsunaga16 used a modified “M”plasty to correct the epicanthal folds.
Fuente17 created a transposition flap whose base, in the medial canthal region, is taken from the posterior surface of the epicanthal fold.
Jordan18 did not remove skin over the epicanthal fold. He removed excessive underlying muscle beneath the fold and attaching the skin edges with “a deep tissue approach” .
Yoon19 modified the Mustard’e technique as so called “one-armed jumping man incision” . Wu20 used the idea of square-flap method21 to correct the epicanthal folds.
Park2 used Z-epicanthoplasty, which was similar to the way Fuente introduced. Materials and Methods From 1989-1 to 1997-11, we had performed the extended Y-V epicanthoplasty in one hundred and forty eight cases. The age ranged from 4 years to 59 years, averaged 27.3 years. (Table I) The follow-up period was ranged from one month to 7 years.
The indications of extended Y-V epicanthoplasty are presence of epicanthal web and 1) widened distance between the eyes (greater than 3.5 cm); 2) congenital ptosis; 3) congenital entropion; 4) telecanthus.
Among the 148 cases, 143 cases received the procedure for correcting Oriental epicanthal folds and 5 of them, for congenital palpebral anomalies. 12 cases received extended Y-V epicanthoplasty alone.
In the other 135 cases, other aesthetic procedures were combined with extended Y-V epicanthoplasty. The detailed data was shown on Table II.
Epicanthoplasty with Modified “Y-V” Advancement Procedure Abstract The presence of epicanthal folds and lack of supratarsal folds are unique features in most of Asian eyelids. There are many surgical procedures designed to eliminate epicanthal folds.
However, scarring on medial canthus is the main obstacle for surgeons to overcome. From 1989-1 to 1997-11, we used modified “Y-V” advancement procedures to correct epicanthal folds in Asian eyelids in 148 cases.
Five cases of them are congenital palpebral anomalies including congenital entropion, congenital ptosis and Down syndrome.
Neither lacrimal apparatus injury nor asymmetry of the eyes was noted. One case received revision surgery because of resultant unnatural supratarsal fold.
One case received intralesional injection of triamcinolone six months after operation for epicanthal hypertrophic scar.
We thought that the modified “Y-V” advancement procedure could make least scarring on medial canthus in correcting Oriental epicanthal folds and congenital palpebral anomalies. It can be also combined with blepharoplasties and corrective procedures of eyelids simultaneously. Introduction Creation of a supratarsal fold is the most frequent procedure performed in cosmetic surgery in Orientals. However, the presence of epicanthal fold weakens the surgical result.
Many surgeons persuaded patients to accept their presence in order not to risk the scarring on medial canthus by epicanthoplasty.
Ree and Wood-Smith1 reported that operations to correct the epicanthal fold can be fraught with problems and may result in unsightly scarring of the eyelids. Park2 classified medial canthus into four types.
Most of the Oriental eyelids with a supratarasal fold fall into type III. Fernandez3 summarized that 50% of all Orientals lacked a supratarsal fold. Though the incidence of epicanthal fold is not known, we found most of Orientals has an epicanthal fold of varying prominence whether a supratarsal fold is present or not.
Many methods had been mentioned to correct congenital epicanthus in literature.4-13. Some of them are too extensive to correct the Asian epicanthal folds and result in unsightly scar. Several techniques unique for Asian epicanthal folds had been designed.
The late Dr. Junichi Uchida14 introduced his spilt V-W plasty in 1962, which is still popular in epicanthoplasty in Oriental eyes. Flowers15 modified Uchida’s technique and Matsunaga16 used a modified “M”plasty to correct the epicanthal folds.
Fuente17 created a transposition flap whose base, in the medial canthal region, is taken from the posterior surface of the epicanthal fold.
Jordan18 did not remove skin over the epicanthal fold. He removed excessive underlying muscle beneath the fold and attaching the skin edges with “a deep tissue approach”.
Yoon19 modified the Mustard’e technique as so called “one-armed jumping man incision”.
Wu20 used the idea of square-flap method21 to correct the epicanthal folds.
Park2 used Z-epicanthoplasty, which was similar to the way Fuente introduced. Materials and Methods From 1989-1 to 1997-11, we had performed the extended Y-V epicanthoplasty in one hundred and forty eight cases.
The age ranged from 4 years to 59 years, averaged 27.3 years.
The follow-up period was ranged from one month to 7 years. The indications of extended Y-V epicanthoplasty are presence of epicanthal web and
1) widened distance between the eyes (greater than 3.5 cm); 2) congenital ptosis; 3) congenital entropion; 4) telecanthus. Among the 148 cases, 143 cases received the procedure for correcting Oriental epicanthal folds and 5 of them, for congenital palpebral anomalies.
12 cases received extended Y-V epicanthoplasty alone. In the other 135 cases, other aesthetic procedures were combined with extended Y-V epicanthoplasty.
Magic Epi Method
The actual Magic Epi method make incision under the cilia of lower eyelids and makes no noticeable scar. The size of scar is very small and barely noticeable, but it is not "no" scar.
新开眼角手术: 现在有更先进的手术方式，新手术方式是眼角上不会留疤痕。在下眼线处会有一条疤痕，这疤痕是会变淡 ，但是不会完全没有的。 疤痕是几乎都不见的。下眼睫毛的下边有一条很细很细的线。距离近一般都看不见可是有的人呢按照自己皮肤的体制疤痕有点看得出来。
新开眼角手术: 现在有更先进的手术方式，新手术方式是眼角上不会留疤痕。在下眼线处会有一条疤痕，这疤痕是会变淡 ，但是不会完全没有的。 疤痕是几乎都不见的。下眼睫毛的下边有一条很细很细的线。距离近一般都看不见可是有的人呢按照自己皮肤的体制疤痕有点看得出来。
Nose Implant
L implant basically makes a bulbous/fleshy nose BIGGER. unless you have a small nose(low bridge small nostrils), you're not really suitable for this. i wanted to get it too, but after opinions from other forummers and dr chuang himself, he says that L implant will only make bulbous noses bigger. does not help with the tip. if you have a bulbous tip, the solution is only to remove excess cartilage and harvest new or existing ones for tip projection. yen can afford to have it because i think she has a rather ok nose to start with, not very fleshy at the tip.
Is GORTEX Really that unsafe compared to Silicone?
A Multicenter evaluation of the safety of Gore-Tex as an implant in Asian rhinoplasty Authors: Jin, Hong-Ryul; Lee, Joo-Yeon; Yeon, Je-Yeob; Rhee, Chae-Seo Source: American Journal of Rhinology, Volume 20, Number 6, November-December 2006 , pp. 615-619(5) Publisher:
OceanSide Publications, Inc Background: A retrospective multicenter study examined the safety of Gore-Tex as a nasal implant in rhinoplasty. Methods: This study involved 853 patients (656 primary surgeries and 197 secondary surgeries) who had undergone rhinoplasty and used Gore-Tex either at the dorsum or at the nasal tip. Data were extracted from the medical records by surgeons and entered on a standard form. Data included the information about the demographics and history of the patient, method and results of surgery, complications, follow-up, and various factors believed to predispose to complications. Results: The average follow-up period was 18 months. Overall complication rate associated with Gore-Tex was 2.5% (21 cases). Infection was the most common complication (18 cases; 2.1%) followed by two cases of seroma and one case of persistent nasal swelling. Among the 21 suffering complications, 19 patients (91%) needed graft removal. Nine cases of infection developed in primary surgeries (1.4%) and nine cases developed in secondary surgeries (4.6%), which represented a statistically higher complication rate in those undergoing secondary surgery (p = 0.0062). Infections developed within 1 month in five cases and nine cases developed infection >6 months postoperatively. Other complications including esthetic problems were identified in 16 cases (1.9%). [color=red]Conclusion: Gore-Tex should be used judiciously in rhinoplasty because of a 2.1% infection rate, a risk that is higher still after secondary surgery; moreover, once infected, Gore-Tex implants usually require removal. Document Type: Research article DOI: 10.2500/ajr.2006.20.2948 Problems of Expanded Polytetrafluoroethylene (Gore-Tex(R)) in Augmentation Rhinoplasty. Yang SJ, Lee JH, Tark MS. Dr. Yang's Institute of Rhinoplasty, Korea. Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Seoul, Korea. Augmentation rhinoplasty is one of the most popular aesthetic procedures in Asians. Numerous alloplastic implants have been used, however alloplastic implants may cause many problems in nasal and perinasal areas because of thin soft tissue cover. For these reasons, an ideal implant should be nonpalpable, readily exchangeable and biocompatible. Among these alloplastic implants, Gore-Tex(R) is a polymer of carbon bound to fluorine composed of solid nodes connected by very fine fibers. It has been reported that this material become permeated and surrounded by mature connective tissue, forming a strong supporting envelop for the material, yet the implant is easily removed because of limited tissue ingrowth. Since it's development, Gore-Tex(R) has found many applications in the field of facial plastic and reconstructive surgery. From November, 2001 to December, 2002, Gore-Tex(R) implants were removed from 17 patients due to several problems such as; decreased dorsal height, tip deformity, chronic inflammation. The implants were very hard to remove and coinciding injury of the surrounding tissue were inevitable. An analysis of the length and thickness changes in these removed implants was made. The results showed, decrease in length and thickness with a volume loss averaging, 46.3% in 45x4.0mm implants, 49.3% in 50x5.0mm implants. In view of the experiences of 17 cases of Gore-Tex(R) implants in rhinoplasty, we have concluded that Gore-Tex(R) implants were structurally unstable, fibrovascular tissue ingrowth into pores were minimal, the implants were very hard to remove and the implants caused a postoperative volume reduction. Therefore, Gore-Tex(R) use in augmentation rhinoplasty should be approached with caution.[/color]
OceanSide Publications, Inc Background: A retrospective multicenter study examined the safety of Gore-Tex as a nasal implant in rhinoplasty. Methods: This study involved 853 patients (656 primary surgeries and 197 secondary surgeries) who had undergone rhinoplasty and used Gore-Tex either at the dorsum or at the nasal tip. Data were extracted from the medical records by surgeons and entered on a standard form. Data included the information about the demographics and history of the patient, method and results of surgery, complications, follow-up, and various factors believed to predispose to complications. Results: The average follow-up period was 18 months. Overall complication rate associated with Gore-Tex was 2.5% (21 cases). Infection was the most common complication (18 cases; 2.1%) followed by two cases of seroma and one case of persistent nasal swelling. Among the 21 suffering complications, 19 patients (91%) needed graft removal. Nine cases of infection developed in primary surgeries (1.4%) and nine cases developed in secondary surgeries (4.6%), which represented a statistically higher complication rate in those undergoing secondary surgery (p = 0.0062). Infections developed within 1 month in five cases and nine cases developed infection >6 months postoperatively. Other complications including esthetic problems were identified in 16 cases (1.9%). [color=red]Conclusion: Gore-Tex should be used judiciously in rhinoplasty because of a 2.1% infection rate, a risk that is higher still after secondary surgery; moreover, once infected, Gore-Tex implants usually require removal. Document Type: Research article DOI: 10.2500/ajr.2006.20.2948 Problems of Expanded Polytetrafluoroethylene (Gore-Tex(R)) in Augmentation Rhinoplasty. Yang SJ, Lee JH, Tark MS. Dr. Yang's Institute of Rhinoplasty, Korea. Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University, Seoul, Korea. Augmentation rhinoplasty is one of the most popular aesthetic procedures in Asians. Numerous alloplastic implants have been used, however alloplastic implants may cause many problems in nasal and perinasal areas because of thin soft tissue cover. For these reasons, an ideal implant should be nonpalpable, readily exchangeable and biocompatible. Among these alloplastic implants, Gore-Tex(R) is a polymer of carbon bound to fluorine composed of solid nodes connected by very fine fibers. It has been reported that this material become permeated and surrounded by mature connective tissue, forming a strong supporting envelop for the material, yet the implant is easily removed because of limited tissue ingrowth. Since it's development, Gore-Tex(R) has found many applications in the field of facial plastic and reconstructive surgery. From November, 2001 to December, 2002, Gore-Tex(R) implants were removed from 17 patients due to several problems such as; decreased dorsal height, tip deformity, chronic inflammation. The implants were very hard to remove and coinciding injury of the surrounding tissue were inevitable. An analysis of the length and thickness changes in these removed implants was made. The results showed, decrease in length and thickness with a volume loss averaging, 46.3% in 45x4.0mm implants, 49.3% in 50x5.0mm implants. In view of the experiences of 17 cases of Gore-Tex(R) implants in rhinoplasty, we have concluded that Gore-Tex(R) implants were structurally unstable, fibrovascular tissue ingrowth into pores were minimal, the implants were very hard to remove and the implants caused a postoperative volume reduction. Therefore, Gore-Tex(R) use in augmentation rhinoplasty should be approached with caution.[/color]
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