(a) Positioning of implanted prosthesis: In order to prevent deflection of the nasal prosthesis after implantation, the standard median line of the nose can be drawn before surgery. The golden point is determined: the recipient takes a flat position, the midpoint of the line between the two eyebrows and the midpoint of the line between the inner canthus of the two eyes is the golden point, and the upper end of the prosthesis should be placed in this position. A midpoint is determined on the tip of the nose directly opposite to the lip bead, and a line is drawn connecting the tip of the nose and the golden point, which is the midline of the nasal bridge, and whether the prosthesis is deflected by this line after placement. (B) Implantation incision selection: The incisional approach for rhinoplasty has an intranasal approach and an external nasal approach, and there are many kinds of variant incisions. 1, butterfly-shaped (bird-shaped) incision along the medial edge of bilateral nostrils, and then converge in the lower part of the nasal column. The advantages are adequate exposure, easy operation, and the skin of the nasal columella can be pushed upward to elevate the nasal tip through the V-Y form. The disadvantage is that the scar is obvious in the short term. 2.Nasal vestibular incision An incision along one side of the nasal vestibular rim. The advantage is that the incision is hidden and easy to operate, and it is the best incision for silicone implant rhinoplasty. The disadvantage is that the separation of the contralateral side of the incision is often not in place for beginners, and the root of the prosthesis is easily skewed to the opposite side, making the placement of the prosthesis slightly difficult. 3.Nasal Column Incision There are various transverse and longitudinal incisions, which are fully exposed and easy to operate; the incision scar is more obvious in the short term. (C) Anesthesia: local infiltration anesthesia or double infraorbital canal block anesthesia with 2% lidocaine or procaine. Local infiltration anesthesia is injected at the incision with a small amount of anesthetic, and then injected while entering the needle until the nasal root area, the closer the nasal root area, the less the amount of anesthetic should be. This will facilitate intraoperative observation and reduce postoperative swelling. When the nasal root area after injection, the needle back to the original injection point near the root of the nasal small column to inject a little anesthetic. (IV) Separation: use small scissors with rounded blunt curved head to peel upward against the nasal cartilage more than 2 mm above the arch point (junction of nasal bone and nasal cartilage), cut open the nasal periosteum, use the nasal periosteal stripper to lift the nasal dorsal fascia from the periosteal surface at 45o from the periosteal cut until 1 to 2 mm above the golden point, and operate with the assistance of the left thumb and index finger in the nasal root area with touch pressure to prevent the direction of peeling from being skewed, at which time the whole layer of nasal dorsum can be felt The fascial tissue is separated from the bone surface. (e) Prosthesis placement: the sculpted prosthesis is placed into the separated cavity with a mosquito-type clamp. The correct level to put the prosthesis is between the separated dorsal nasal fascia and the nasal bone, and the sign is no movement of the prosthesis in the root area after the prosthesis is placed. Observe whether the height and width are suitable, and whether there is any skew, etc. until satisfied, then squeeze out the blood accumulated in the cavity and suture the skin. (f) Postoperative treatment: external fixation is generally not necessary, and the sutures are removed in 6-7 days. Do not push and touch the dorsum of the nose before suture removal to prevent displacement of the prosthesis. Tell to avoid external impact on the nose.