Hybrid Progress of the Chin: Combining cartilage cuttings and slices to increase the chin during rhinoplasty

A well -fitted chin is an aesthetically pleasing feature in men and women [12]. When evaluating the lower part of the face, a careful examination is of the most important importance for maintaining a youthful, physical and attractive appearance. However, mentum is a complex area for evaluation and treatment due to the number of structural variables, which include lower jaw length, jaw angle, height and width of the chin, skin thickness, subcutaneous tissue and cervical angles. As a result, it is important to evaluate facial asymmetries and the balance between the middle -sided and the lower face prior to the realization of any face process [13]. Therefore, plastic surgeons should add chin surgery procedures to rhinoplasty procedures. Different surgical and non -surgical procedures are used to increase the chin. These include bone gonnecting, fat cuttings, osteopic implants, aloplastic implants and tissue fillers [6]. Osteiotic gonnects and aloplasmic implants often scare patients and there is no doubt that these are expensive processes with increased risk of morbidity. Mild to moderate microgenic patients may not need osteotomies or implants, and the growth menoplasty may be sufficient to balancing the face profile. In the literature, the use of nasal canned or diaphragm cartilage has been described by Aufricht [14]. The pilgrims of the top, the skull and the tibia are also popular donor seats for bone cuttings to increase the chin. According to the literature, the harvest from the oral cavity, such as the Ramus rumors and bones, is also often performed [15]. However, these procedures are complex and have high morbidity rates for patients. According to many authors, autologous cartilage and fat cuttings represent excellent materials as first choice for tissue growth [16, 17]. However, the main problem in the use of biological materials is the absorption potential and the main advantages of cartilage grafts are that they are sustainable even with poor blood supply and a minimal absorption rate [18]. The long -term effects of fat vaccination are often frustrating due to the unpredictable partial absorption of fat grafts. Several studies have reported 30-70% absorption rates within one year [19]. Therefore, according to the literature, serial fat injections may be needed to increase the chin [20]. Patients in our study were evaluated in the sixth month to measure the angles of LEGAN after surgery and did secondary fat transplantation into five patients to correct mild asymmetries. Since organic cuttings have a risk of infection during the early postoperative period due to alien implants, we have been washed the cartilage tissue with a 1-4 diluted povidone-Iodine solution. We applied postoperative antibiotics before and postoperative dose 12 hours after surgery. We did not experience infections after surgery. Also, after completing the early period, in long -term surveillance, we did not see delayed start infections due to the completion and increased vascularity of the biological grafts [21].

One of the major problems with osteotheistic glanding is nerve damage [22]. To minimize the risk of hallucination, surgeons must remember that the lower cellular nerve begins as inferior to the psychic foramen while the loop is in front of it [23]. In our study, the core of the increase was above the apartment of the deep level of fat, so the primary advantage of our process is that there is no risk of damage to the nerve or mental muscles. Autologous fat transplantation of facial fat compartments has been shown to improve facial aesthetics. However, despite the increased use of fat transplantation to fill the aging, few reports have described the fat transplant as a means of increasing the chin [9]. Increasing the fat fat can restore the loss of aging tumor and soften the puppet lines that are difficult to correct with traditional surgical techniques such as osteoporical glanding or implants. In such cases, autologous fat transplantation facilitates asymmetries that cannot be corrected for the bottom using the above -mentioned techniques.

Fat cuttings are effective in increasing the mentum, but anterior profits with fat cuttings are often about 2.4 mm. In Chin’s hybrid techniques, this gain can be increased to 4.4 mm, depending on the amount of cartilage cuttings. The evaluation of the Gonzalez-Olloa line, the silver line and the corner of Legan should only serve as reference levels because facial aesthetic analysis is complex [24]. The lower lip should usually have a prominent position similar to the chin projection. Excessive lower viewing or mentum may [25]. Therefore, in 11 patients, we have also injected a lavomy aspect to achieve a better aesthetic effect. In the literature, some reports indicate that respiratory mucous membranes or informal cystic formations may be developed after using a nasal osteopic graft [26].

The cause of this clinical manifestation may be explained by the presence of epithelial cells that have not been properly removed from the estimated osteopic implant. However, in our study, no early or delayed complications were observed in any of the patients included. Patients who designed Chin’s hybrid progress but could not harvest sufficient cartilage grafts had only injection of fat cuttings and these patients should have been informed of the ear cartilage graft in advance. Also, fat transplantation and cartilage transplantation in the long run compared to aloplasmic implants. Differences of certain source growth techniques are presented in the table 2. Although the amount of cartilage to be removed from patients is unknown, cartilage implantation is decided in intraoperative. This is one of the restrictions of the study and the size of the study sample, retrospective design and surveillance time are other restrictions. However, this method shows that autologous implants can be used as an alternative to aloplastic implants. No additional donor area is required when performed simultaneously with rhinoplasty function. Diaphema cartilage cuttings can be more easily shaped by cartilage cuttings. The implantation of cartilage diaphragm by injection of fat ensures long -term permanence.