Background Paranasal augmentation was effective management for midface concavity. Both alloplastic graft (e.g. silicone, porous polyethylene, or expanded polytetrafluorethylene) and autologous tissue (e.g. costal cartilage) were used for paranasal augmentation. The study aims to evaluate the safety and efficacy of paranasal augmentation using diced costal cartilage for midface concavity. Methods A retrospective review of demographic data and complications was conducted for consecutive patients who underwent paranasal augmentation using diced costal cartilage. A questionnaire was used for investigating the patient's satisfaction (i.e. overall satisfaction, bilateral alar bases symmetry, improvement of concavity, and foreign body sensation). Patients' photographs were used to evaluate aesthetic outcomes (i.e. overall satisfaction, bilateral alar bases symmetry, and improvement of concavity) by third-party doctors. Results Sixty-eight patients (60 females; mean age, 27.1 ± 8.2 years) were included. During a median follow-up of 6.5 months, costal cartilage migration occurred in 13 (19.1%) patients and partial resorption occurred in 2 (2.9%) patients. Seventy-five per cent of the patients and 98.5% of the doctors reported overall satisfaction. Bilateral alar bases asymmetry by 20 (29.4%) patients, no improvement of concavity by 13 (19.1%) patients, and foreign body sensation by 13 (19.1%) patients were reported. While bilateral alar bases asymmetry was not reported, improvement of concavity was reported in 67 (98.5%) patients by third-party doctors. On both univariate and multivariate analyses, improvement of concavity was significantly associated with patients' overall satisfaction (p = 0.008 and 0.045, respectively), while bilateral alar bases symmetry and foreign body sensation were not (all p [ 0.05). Conclusions Paranasal augmentation using diced costal cartilage seems a safe and effective method for midface concavity. Improvement of concavity may be significantly associated with patients' overall satisfaction.
Background An enduringly stable tip graft is the key to achieve successful rhinoplasty case. However, the intrinsic nature of rib graft warping renders major unpredictability for the long-term outcome. Objectives The aim of this study was to detail and validate the utilization of a tip graft that is characterized by the circumferential split on the tip graft, which consequently renders a shape similar to the letter of X (Chi). Methods The counterrotating force applied intraoperatively and the complications that arose were collected retrospectively. Three-dimensional stereophotogrammetric evaluations of patients was performed. Anthropometric points were analyzed in a blinded fashion. Outcome variables were tip projection, nasal length, tip rotation and the n-prn angulation. Results Forty-five female patients, ranging in age from 18 to 41 years (average 28.5 years) completed the study. In all cases, the X graft was applied as one essential element for enhancing tip projection. Postoperative analysis showed great maintenance of tip position over time, evidenced by the insignificant change of n-prn angulation. Other postoperative evaluations including tip projection, nasal length and nasolabial angle had significant improvement. The differences were not statistically different between short- and long-term follow-up. Conclusions The X graft effectively mitigate the negative impact of graft warping. It is the ultimate form for tip support and elongating short noses. It has the merits of being versatility and flexibility when it comes to utilizing in establishing a strong and sustainable tip support in East Asian rhinoplasty.
In person re-identification (re-ID) task, it is still challenging to learn discriminative representation by deep learning, due to limited data. Generally speaking, the model will get better performance when increasing the amount of data. The addition of similar classes strengthens the ability of the classifier to identify similar identities, thereby improving the discrimination of representation. In this paper, we propose a Diverse and Compact Transformer (DC-Former) that can achieve a similar effect by splitting embedding space into multiple diverse and compact subspaces. Compact embedding subspace helps model learn more robust and discriminative embedding to identify similar classes. And the fusion of these diverse embeddings containing more fine-grained information can further improve the effect of re-ID. Specifically, multiple class tokens are used in vision transformer to represent multiple embedding spaces. Then, a self-diverse constraint (SDC) is applied to these spaces to push them away from each other, which makes each embedding space diverse and compact. Further, a dynamic weight controller (DWC) is further designed for balancing the relative importance among them during training. The experimental results of our method are promising, which surpass previous state-of-the-art methods on several commonly used person re-ID benchmarks. https://github.com/ant-research/Diverseand-Compact-Transformer
Background Insufficient support of the nasal septum due to congenital or secondary deficiency leads to severe saddle nose deformity which presents an unpleasant appearance. Objectives The purpose of this study is to present our approach to constructing a costal cartilaginous framework to correct severe saddle nose deformities with autologous costal cartilage. Methods A retrospective analysis was conducted of patients underwent correction of severe saddle nose deformity (Type II to Type IV) by a senior surgeon from January 2018 to January 2022. Preoperative and postoperative measurements were conducted to evaluate the surgical outcomes. Results A total of 41 patients aged from 15 to 50 years completed the study. The average follow-up time was 20.6 months. No short-term complication was observed. Revision operations were performed on three patients. All cases were satisfied with the aesthetic results. Analysis of objective measurements showed nasofrontal angle, columellar-labial angle, and tip projection improved significantly in Type II cases, nasofrontal angle and tip projection improved significantly in Type III cases, and tip projection improved significantly in Type IV cases. Conclusions Application of this modified costal cartilaginous framework which consists of a fairly stable foundation layer and an aesthetic contour layer of block costal cartilage has achieved satisfactory results in the long-term, which focuses on the aesthetic outcome while correcting the saddle nose deformity.
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