Q: “Now it’s popular to have a nose job with injections, why do you still want to put prosthesis here?” A: Regardless of the cost, safety, or post-operative effect, rhinoplasty is superior to injections: 1, price, injectable filling agent 1 ml on about 4,000 yuan, plus injection operation fees, the total cost of more than 5,000, but only last 7 to 9 months (now the legal injection filling agent is basically absorbable, permanent filling agent due to safety issues in principle prohibited 2.Safety, once infection occurs after injection, it is impossible to take out all the injections at once, resulting in a long time of drainage and medication exchange, and there are consequences; after implantation of prosthesis No matter what accident happens, as long as the prosthesis is simply removed, all after-effects can be eliminated. Another safety issue that should not be overlooked is the vascular embolism caused by the injection. I have seen a black necrosis of the tip of the nose after rhinoplasty injection in Beijing, because the filling agent was injected into the blood vessels that nourish the tip of the nose and embolism occurred; at an academic meeting, I heard the director of the plastic surgery department of Zhongshan Hospital say that his lover was from Shanghai Eye, Ear, Nose and Waiting Hospital, and in 2014, the hospital admitted four cases of blindness in one eye from all over the world, which was caused by rhinoplasty injection, resulting in embolism of the blood vessels related to the eye. 3, the effect, the injectable filling agent is fundamentally soft tissue filling agent, its filling effect gives a soft feeling, rather than the nose should be hard feeling, and once the filling agent spread around, the surgical effect will be completely out of control; and the texture of the prosthesis is closer to the nasal bone, the filling effect is closer to the natural nasal bone. Therefore, the so-called “now popular injection rhinoplasty” is only the result of repeated propaganda and misinformation by some medical beauty institutions (legal or not), out of economic interests, or due to conditions that prevent them from carrying out surgical procedures. There is only one advantage of injectable rhinoplasty, that is, small damage, light swelling and fast recovery, which cannot be denied. But beauty should be a lifelong plan, should never be greedy for the convenience of the moment. I think there is only one situation where you can consider rhinoplasty injections, and that is if you are going to have a wedding (or other very important unavoidable event) within a week and decide to rush into it. Other than that, it is a foolish move. Q: “I heard that the expansion material is more advanced than silicone, why do you still suggest I put silicone implants?” A: Inflatable material is much more expensive than silicone, and the technology is really a bit higher, but this does not mean that it is the material of choice for rhinoplasty. The characteristics of the expansion is densely packed with tiny microscopic pores, tiny blood vessels and other human tissue can grow into it, and thus firmly integrated with the body, medical terminology called good tissue compatibility, not easily rejected by the body. But in fact, for the following reasons, bulging may not be superior to silicone: 1, bulging is indeed not easy to be rejected by the human body, but silicone rejection in the true sense of the word is rare (most of the prosthesis exposed or the main reason for tension). In fact, after rhinoplasty most often occurs not rejection, but the prosthesis is placed crooked. There are many factors affecting the malposition of the prosthesis, even the most experienced doctor, if he has a scientific attitude, he would not dare to guarantee that he would never put the prosthesis crooked before surgery. And once the prosthesis is not positioned in the need for secondary surgery to correct, that the expansion and human tissue due to a tighter bond, the position is stable, the operation is relatively troublesome, while the silicone prosthesis is much easier. In other words, the main advantage of the bulge (good tissue compatibility), the opportunity to embody very little; and in the most frequent complications, this feature has become a disadvantage. 2, due to the characteristics of the bulge porosity, once the aseptic operation is not tight enough, bacteria into the operating area, it is easy to stay in the pores of the prosthesis to proliferate and lead to infection. The rhinoplasty area is near the nostrils and mouth, it is difficult to do in the strict sense of the class I sterile incision, belongs to the class II incision surgery. 3, the expansion is softer, in need of greater support strength occasions, silicone better meet the requirements. 4, the expansion is called “expansion” body, because it is implanted due to the growth of human vascular tissue, the volume will expand, and the amount of expansion doctors are very good. The amount of expansion is difficult to estimate and control the doctor, may cause the dorsum of the nose after surgery gradually widen the adverse surgical effect. 5, expensive. Of course, this will not be an obstacle for those who are financially well-off. In short, I personally believe that only when a patient is confirmed to occur after silicone rejection (the probability is very low), the replacement of the expansion material prosthesis will become a more reasonable choice, and should not be the first choice for initial surgery. Q: “I’m going to have a rhinoplasty with cartilage, and I’ve heard that the prosthesis will have to be replaced after a few years, right?” A: After rhinoplasty with silicone implants, there is no need to replace them for life as long as no complications occur. Caucasians cannot use silicone prosthesis due to their physique, and mostly consider autologous cartilage, preferably nasal septal cartilage, followed by rib cartilage. However, the desirable amount of nasal septal cartilage for our yellow people is small; taking rib cartilage is not only traumatic and leaves scar after surgery, but also the cartilage absorbs a lot after transplantation and is prone to bending (Caucasians are not easy to bend), so autologous cartilage is generally not considered as the main material for rhinoplasty, while a small amount of nasal septal cartilage or auricular cartilage can be used in certain key parts as appropriate to play a specific auxiliary role. Q: “No one else has had their nose done without a scar, why do you say I will have a scar here on the nasal column for this surgery?” A: If it is just an ordinary rhinoplasty to raise the bridge of the nose and does not require changing the shape of the nose (tip and wings), only a small incision needs to be made in the nostril and the scar will not be noticed by outsiders. However, if you request to change the shape of the head of the nose, the doctor has to make a series of adjustments to the cartilage structure of the area, etc. Sometimes it is necessary to add auxiliary incisions and leave scars, but usually these scars are not obvious. Q: “Look at the beautiful artificial beauty, you can’t even make my nose a little smaller?” A: Plastic surgeons are not everything, look around, not all are beautiful and handsome if you have money. The problem is that now the plastic surgery technology, some things can be done, some can not do. For example: single eyelids open double eyelids easy, eyes too short want to lengthen it is difficult, only a limited open a little; lip repair thin can be, but the mouth big want to do small can not be done; eyes to the bottom of the nose and then to the vertical distance between the lips can not be changed, if the vertical position of the five senses out of proportion, the doctor can not help. Artificial beauty is just a kind of commercial propaganda, is to have a specific object, is to find such a person, her face has many defects, and these defects can be solved by plastic surgery makeup. If a doctor says he can do everything you want, how beautiful you want to be, as long as you pay money, then he is not a responsible plastic surgeon. In terms of our yellow rhinoplasty, large nose reduction is one of the most challenging challenges, we can work in the direction of reduction, but we can’t be sure how much we can reduce, and it’s even harder to guarantee that we can change the big bulging nose into a clear, angular, bony one.