Shanghai Liu ChaofengLead: Understand nasal base filling in one sentence
Nasal base fillingIt is through implantation of prostheses, autologous cartilage or injection of hyaluronic acid in the concave area on both sides of the nasal alae and below the nasal column to support the middle of the pad surface and improve the visual effect of "concave and convex mouth"nasal plasticProject. It fitsPseudo-convex mouth (depressed nasal base type)Population: If mouth protrusion is caused by tooth protrusion or jaw development (bony/dental mouth protrusion), nasal base filling can only assist in improvement and needs to be evaluated in the Orthodontic and Orthodontic Orthodontics Department.
1. What is the nasal foundation: the neglected "mid-plane foundation"
Nasal baseIt refers to the base area at the junction of the nose and the upper lip, anatomically corresponding to the periphery of the piriform foramen of the maxilla, and can be subdivided into three subregions:alar base(Both sides of the nose, the starting point of the upper section of the decree line),base of columella(the junction between the columella and the central human body) and the transition area between the two.
The base of the nose is equivalent to the "foundation" of the nose: the foundation is full, the nose is supported, the lips are retracted, and the side contours are smooth; if the foundation is depressed, three typical visual problems will occur:
Show mouth convex: The base of the nose recedes to set off the protruding lips. It looks like a "convex mouth" on the side, and the corners of the nose and lips become sharp (less than 90°).
The upper section of the decree line is deepened: The depression in the base of the nose makes the starting point of the decree line "fold down" too early, showing fatigue and age.
Midface flat: Even if the mountain roots and bridge of the bridge are not low, the whole face still lacks three-dimensional feeling, and the smile is especially obvious.
Quick self-test: Look at the mirror sideways and use a pen to gently press the tip of the nose and chin-if the lips are obviously protruding beyond the line and there is a significant bony depression next to the nose, there is a high probability that there is a depression in the nasal base; however, lateral image evaluation is still needed to distinguish between "depressed type" and "bony/dental protruding mouth."
2. Depression of the nose base ≠ protrusion of the mouth: distinguish three types first
"protruding mouth" is the result, but there are three types of causes, which directly determine whether nasal base filling is useful:
Pseudo-convex mouth (depressed nasal base type): The teeth bite normally, and the problem lies in the lack of bone mass at the nasal base and the edge of the piriform foramen--Nasal base filling is the preferred solutionThe improvement is immediate.
dental protruding mouth: Due to anterior lip inclination and protrusion, orthodontic treatment (correction of teeth) is the first choice; if there is a dent in the nasal base at the same time, it can be combined with filling after orthodontic treatment to add to the cake.
bony mouth: The overall protrusion or abnormal development of the maxilla requires orthognathic surgery evaluation; nasal base filling alone cannot be fundamentally improved, but blind filling may appear bloated in the middle of the face.
Therefore, the standard face-to-face diagnosis process is: first take lateral head images or CT to determine the condition of the bones and teeth, confirm that they are concave, and then discuss what to fill and how much to fill.
3. How to choose three filling materials: hyaluronic acid, prosthesis, and autologous cartilage
1. Hyaluronic acid injection (limited to nasal base use)
Select macromolecular and strong supporting cross-linked hyaluronic acid and inject it into the upper layer of periosteum.advantages: Non-invasive, ready-to-go, reversible with lytic enzyme, suitable for people who have mild depressions or want to "test the effect" first.limited: Re-injection is required for approximately 6-12 months; the nasal base is adjacent to the facial artery branch, and injection must be performed by a doctor familiar with the anatomical level to be alert to the risk of vascular embolism.
2. Prosthesis implantation (silicone/expanded body, commonly known as "noble surgery")
Apply the carved silicone or expanded prosthesis to the bone surface of the piriform foramen through an intraoral incision or nasal margin incision.advantages: Last-lasting and stable effect, strong support, preferred for moderate to severe depressions.limited: There is the possibility of infection and prosthesis migration/downward movement. Attention should be paid to oral cleaning during the intraoral incision; once infection needs to be removed, secondary implantation will be evaluated after recovery.
3. Autogenous cartilage/autogenous tissue filling
multi-usenasal synthesisDuring surgery, the remaining costal cartilage (granular or lumpy) is removed from the base of the nose.advantages: Autologous tissue has no rejection and has good anti-infection properties. It is especially suitable for "smooth operation" simultaneously with costal cartilage nose.limited: Partial absorption (usually 10%-30%) leads to compromised effects; harvesting costal cartilage trauma from the nasal base alone is less cost-effective and is generally used as a combination surgical option.
4. Comparison table of nasal base filling materials
| dimension | hyaluronic acid | Silicone/expanded prosthesis | autologous cartilage |
|---|---|---|---|
| trauma | Minimal (injection) | Middle (intraoral/nasal edge incision) | CUHK (demand area) |
| maintenance time | 6- 12 months | long-term stability | Long-term (partially absorbed) |
| reversibility | Soluble, optimal | Operatively removable | Difficult to remove completely |
| supporting force | Weak-Medium | strong | Medium-Strong |
| main risks | Vascular embolism and uneven absorption | Infection, displacement, downward movement | Absorbing and supplying area trauma |
| suitable for the crowd | Slightly depressed/Want to try the effect first | Moderate to severe depressions seek long-lasting | Concurrent patients with costal cartilage nasal syndrome |
For a more complete horizontal comparison of nasal materials, please refer to the special topic "Full Comparison of Rhinoplasty Materials" in the station.
5. Suitable and unsuitable for the crowd
Suitable for people with nasal base fillings
The mouth was convex on the side but the teeth were normal, and the diagnosis was diagnosed with a depressed nasal base (pseudo-mouth).
The upper section of the decree line is too deep and the "corner" next to the nose is obvious, showing fatigue.
During nasal synthesis, the doctor assessed that the retraction of the nasal base affected the overall profile, and recommended that it be lifted at the same time.
Unsuitable or cautious person
For patients with bony mouth and severe dental mouth, they should go to the orthodontic/orthognathic department for evaluation first. Nasal base filling is not a fundamental solution.
Active infection in the mouth or nasal cavity (high risk of intraoral incision infection).
Pregnancy, lactation, scar constitution, and unrealistic expectations of the effect.
6. Risks, Costs and Recovery
risk: For injections, the focus should be on preventing vascular embolism (select regular products + doctors familiar with anatomy); prosthetics are mainly infection and displacement. Cleaning the mouth after surgery and avoiding vigorous kneading is the key; if persistent redness, swelling, heat and pain occur, follow-up should be carried out promptly. If the infection is conservative and ineffective, the prosthesis needs to be removed. For related knowledge of repair, please refer to the "Guide to Failed Nasal Plastic Repair" in the station.
costs: Hyaluronic acid is charged per unit, and prosthesis/autogenous cartilage is charged per operation; whether it is combined with the nose, material brand, and doctor's qualifications will affect the total price. See the detailed price logic in the stationHow much does nasal surgery cost?Topic.
recovery: There is basically no recovery period for injection; the middle face is swollen 3 - 5 days after prosthesis implantation, and the intraoral incision heals in about 7 - 10 days. Avoid biting hard objects and laughing and pulling within 1 month, and naturally set within 1 - 3 months. The complete timeline can be referred to the stationFull rhinoplasty recovery schedule。
Author of this article:Dr. Liu Chaofeng, the content is compiled and released by its Medical Beauty Strategies section. Please indicate the source for reprinting.
VII. FAQ
Q1: How to improve nasal base depression?
A: Macromolecule hyaluronic acid can be injected for mild depressions (maintained for 6-12 months); for moderate and severe depressions, it is recommended to implant prostheses or combine with nasal synthesis with autologous costal cartilage for a lasting effect. First face-to-face diagnosis confirmed that it belongs to a depressed re-selection plan.
Q2: Can nasal base filling improve mouth protrusion?
A: It can improve the "false mouth protrusion"-that is, the mouth protrusion set off by the depression of the nasal base; it can only assist in modification of dental and bony mouth protrusion, and fundamental improvement requires orthodontic or orthognathic treatment. To determine the type, lateral radiographs are needed for evaluation.
Q3: Is it better to use hyaluronic acid or prosthesis for nasal base filling?
A: Mild depression, want to test the effect first, afraid of surgery → hyaluronic acid; moderate to severe depression, pursuit of one-time placement → prosthesis; people who do costal cartilage nasal synthesis can use autologous cartilage at the same time. There are no absolute advantages and disadvantages, choose according to the degree of depression and budget.
Q4: Will nasal base filling shift?
A: If the dissection cavity of the prosthesis is too large or poorly fixed, there is a possibility of displacement or sliding. Selecting an experienced doctor and avoiding early extrusion according to the doctor's advice can greatly reduce the risk; hyaluronic acid may have a small amount of dispersion, which is controllable.
Q5: How much does it cost for nasal base filling?
A: Hyaluronic acid is charged per unit and needs to be replenished periodically; prosthesis implantation is a one-time operation cost, which is usually higher than injection but is better in the long term; the cost will be calculated as a whole when combined with the nose. The specific price shall be subject to the face-to-face consultation.
Q6: How to choose nasal base filling and orthognathic surgery?
A: Look at the cause-filling can be used for the depressed nasal base type; the bony mouth protrusion of the maxilla protrusion requires orthognathic surgery evaluation, and filling is just a "makeup" rather than a "root cause." There is no conflict between the two, and the nasal base can still be replenished and refined after some orthognathic surgery.
Q7: Can nasal base filling be done together with rhinoplasty?
A: Yes, and it is often recommended to perform it at the same time-the bridge of the nose, the tip of the nose, and the base of the nose belong to the lateral chain. The overall coordination of the design can also be achieved at one time, and the costal cartilage material can be shared, saving the cost of secondary surgery.
8. Conclusion
The nasal base is the invisible foundation that determines the "high-level feeling" of the side contour. The prerequisite for improvement is to distinguish between the types of convex mouth: concave type and rest assured filling, and orthodontic orthognathic first for dental bones. The materials are selected according to the idea of "mild hyaluronic acid water testing, moderate to severe prostheses in place, nasal synthesis and autologous cartilage at the same time", and then handed over to a doctor familiar with midfacial anatomy to achieve both effect and safety.
Medical disclaimer: This article is popular science content and does not constitute medical advice. Any operation and injection are risky, and the specific plan should be based on a face-to-face evaluation by a qualified doctor.
