硅胶假体隆鼻术后包膜挛缩的临床分级及防治(3)
对于严重包膜挛缩需手术治疗，而修复手术也并非只是单纯假体取出更换。在是否保留已形成包膜方面存在争议，笔者认为，综合考虑尽可能的包膜切除后加以ADM的覆盖或许能有效预防修复术后包膜挛缩。假体更换后的鼻部整体美学形态的修复是整形外科医生面临的困难点，需结合应用鼻部整形美学标准进行鼻部修复重建。相信在未来随着对于隆鼻后包膜挛缩的机制更深入的探索及生物工程技术的发展，使预防及治疗将有更多的选择。
[參考文献]
[1]Kim HS，Park SS，Kim MH，et al.Problems associated with alloplasticmaterials in rhinoplasty[J].Yonsei Med J，2014，55(6)：1617-1623.
[2]Kim YK，Kania K，Nguyen AH.Rhinoplasty with cartilageand alloplastic materials，nasal smas management in asianrhinoplasty，contracture classification，and secondary rhinoplasty withcontracture[J]，Semin Plast Surg，2015，29(4)：255-261.
, http://www.100md.com
[3]Kim YK，Shin S，Kang NH，et al.Contracted nose after siliconeimplantation： a new classification system and treatment algorithm[J].Arch Plast Surg，2017，44(1)：59.
[4]Steiert AE， Boyce M，Sorg H.Capsular contracture by siliconebreast implantsipossible causes，biocompatibility，and prophylacticstrategies [J].Med Devices(default)，2013，6(default)：211-218.
[5]Wan D，Rohrich RJ.Revisiting the management of capsularcontracture in breast augmentation：a systematic review[J].Plast
, 百拇医药
Reconstr Surg，2016，137(3)：826-841.
[6]Suh MK，Lee KH，Harijan A，et al.Augmentation rhinoplasty withsilicone implant covered with acellular dermal matrix[J].J CraniofacSurg，2017，28(2)：445-448.
[7]Sunwoo W，Jung H，Kim DW，et al.Immunohisto chemical analysis ofcapsular contracture in silicone implant rhinoplasty [J].JAMA FacialPlast Surg，2017，19(5)：436-437.
[8]Wolfram D，Rabensteiner E，Grundtman C，et al.T regulatory cells andthl7 cells in perisilicone implant capsular fibrosis[J].Plast ReconstrSurg，2012，129(2)：327e-337e.
, http://www.100md.com
[9]Wick G， Backovic A， Rabensteiner E， et al.The immunology offibrosis： innate and adaptive responses[J].Trends Immunol，2010，31(3)：110-119.
[10]Gruber RP，Galvez MG，Ulvila DD.Postrhinoplasty fibroticsyndrome[J].HNO，2018，66(1)：26-31.
[11]Ferril GR，Wudel JM，Winkler AA.Management of complicationsfrom alloplastic implants in rhinoplasty[J].Curr Opin OtolaryngolHead Neck Surg，2013，21(4)： 372-378.
[12]Jung DH，Moon HJ，Choi SH，et al.Secondary rhinoplasty of theAsian nose： correction of the contracted nose[J].Aesthetic PlastSurg，2004，28(1)： 1-7.
, 百拇医药
[13]Jung DH，Kim BR，Choi JY，et al.Gross and pathologic analysisof long-term silicone implants inserted into the human body foraugmentation rhinoplasty： 221 revision cases[J].Plast ReconstrSurg，2007，120(7)： 1997-2003.
[14]Parker J，Walboomers XF，Von den Hoff JW，et al.Sofit-tissue responseto silicone and poly-L-lactic acid implants with a periodic or randomsurface micropattem[J].J Biomed Mater Res，2002，61(1)：91-98.
[15]Jeong JY，Oh SH，Suh MK，et al.Effective use of a silicone-inducedcapsular flap in secondary asian rhinoplasty [J].Plast Reconstr SurgGlob Open，2014，2(6)：el72.
, http://www.100md.com
[16]Rojvachiranonda N，Pyungtanasup K，Siriwan P，et al.Cadaveric studyof the nasal periosteum and implant position after augmentationrhinoplasty[J].J Craniofac Surg，2012，23(4)：1163-1165.
[17]Kim YS，Hyun DW，Seong SY，et al.Immediate re-insertion of non-autologous materials in revision augmentation rhinoplasty [J].AnnPlast Surg，2015，74(5)：524-527.
[18]Kim JH，Song JW，Park SW.Contracted nose correction withdermofat and conchal cartilage[J].Plast Reconstr Surg GlobOpen，2017，5(4)：el272.
[19]Kwon TK.Complications found in Asian tip surgery [J].Facial PlastSurg，2012，28(2)：238-242., http://www.100md.com(田甜 杨天荣)
[參考文献]
[1]Kim HS，Park SS，Kim MH，et al.Problems associated with alloplasticmaterials in rhinoplasty[J].Yonsei Med J，2014，55(6)：1617-1623.
[2]Kim YK，Kania K，Nguyen AH.Rhinoplasty with cartilageand alloplastic materials，nasal smas management in asianrhinoplasty，contracture classification，and secondary rhinoplasty withcontracture[J]，Semin Plast Surg，2015，29(4)：255-261.
, http://www.100md.com
[3]Kim YK，Shin S，Kang NH，et al.Contracted nose after siliconeimplantation： a new classification system and treatment algorithm[J].Arch Plast Surg，2017，44(1)：59.
[4]Steiert AE， Boyce M，Sorg H.Capsular contracture by siliconebreast implantsipossible causes，biocompatibility，and prophylacticstrategies [J].Med Devices(default)，2013，6(default)：211-218.
[5]Wan D，Rohrich RJ.Revisiting the management of capsularcontracture in breast augmentation：a systematic review[J].Plast
, 百拇医药
Reconstr Surg，2016，137(3)：826-841.
[6]Suh MK，Lee KH，Harijan A，et al.Augmentation rhinoplasty withsilicone implant covered with acellular dermal matrix[J].J CraniofacSurg，2017，28(2)：445-448.
[7]Sunwoo W，Jung H，Kim DW，et al.Immunohisto chemical analysis ofcapsular contracture in silicone implant rhinoplasty [J].JAMA FacialPlast Surg，2017，19(5)：436-437.
[8]Wolfram D，Rabensteiner E，Grundtman C，et al.T regulatory cells andthl7 cells in perisilicone implant capsular fibrosis[J].Plast ReconstrSurg，2012，129(2)：327e-337e.
, http://www.100md.com
[9]Wick G， Backovic A， Rabensteiner E， et al.The immunology offibrosis： innate and adaptive responses[J].Trends Immunol，2010，31(3)：110-119.
[10]Gruber RP，Galvez MG，Ulvila DD.Postrhinoplasty fibroticsyndrome[J].HNO，2018，66(1)：26-31.
[11]Ferril GR，Wudel JM，Winkler AA.Management of complicationsfrom alloplastic implants in rhinoplasty[J].Curr Opin OtolaryngolHead Neck Surg，2013，21(4)： 372-378.
[12]Jung DH，Moon HJ，Choi SH，et al.Secondary rhinoplasty of theAsian nose： correction of the contracted nose[J].Aesthetic PlastSurg，2004，28(1)： 1-7.
, 百拇医药
[13]Jung DH，Kim BR，Choi JY，et al.Gross and pathologic analysisof long-term silicone implants inserted into the human body foraugmentation rhinoplasty： 221 revision cases[J].Plast ReconstrSurg，2007，120(7)： 1997-2003.
[14]Parker J，Walboomers XF，Von den Hoff JW，et al.Sofit-tissue responseto silicone and poly-L-lactic acid implants with a periodic or randomsurface micropattem[J].J Biomed Mater Res，2002，61(1)：91-98.
[15]Jeong JY，Oh SH，Suh MK，et al.Effective use of a silicone-inducedcapsular flap in secondary asian rhinoplasty [J].Plast Reconstr SurgGlob Open，2014，2(6)：el72.
, http://www.100md.com
[16]Rojvachiranonda N，Pyungtanasup K，Siriwan P，et al.Cadaveric studyof the nasal periosteum and implant position after augmentationrhinoplasty[J].J Craniofac Surg，2012，23(4)：1163-1165.
[17]Kim YS，Hyun DW，Seong SY，et al.Immediate re-insertion of non-autologous materials in revision augmentation rhinoplasty [J].AnnPlast Surg，2015，74(5)：524-527.
[18]Kim JH，Song JW，Park SW.Contracted nose correction withdermofat and conchal cartilage[J].Plast Reconstr Surg GlobOpen，2017，5(4)：el272.
[19]Kwon TK.Complications found in Asian tip surgery [J].Facial PlastSurg，2012，28(2)：238-242., http://www.100md.com(田甜 杨天荣)