Low nasal dorsum is one of the main characteristics of Asian noses. Thus, dorsal augmentation is one of the most frequently performed procedure in Asian rhinoplasty. There exists a distinctive difference in preferences of materials used for dorsal augmentation between surgeons of the Asia and the West Nguyen Phan Tu Dung Phd Seemore: https://www.facebook.com/drdunghanquoc

1. My experience on Megaderm for
dorsal Augmentation
Seoul, Korea, 26 June, 2016
Nguyen Phan Tu Dung, PhD, MD
Plastic surgeon, Director of Vietnam JW plastic hospital
Email: drdunghanquoc@gmail.com

2. Define and Describle condition
• Low nasal dorsum is one of the main characteristics
of Asian noses. Thus, dorsal augmentation is one of
the most frequently performed procedure in Asian
rhinoplasty.
• There exists a distinctive difference in preferences of
materials used for dorsal augmentation between
surgeons of the Asia and the West.

3. Autogenous tissues preferred by Western surgeons
provide better safety, but have disadvantages of
1) Lesser satisfaction in the aesthetic aspect,
2) Scars on the donor site,
3) Decreased height or irregularity of the nasal dorsum
due to tissue resorption, and
4) A more complex surgical procedure, as opposed to
implants.
• Thus, use of a implant is still preferred for dorsal
augmentation in Asia.

4. • Silicon implant has been rated as one of the most
widely used material for rhinoplasty and it’s verified
that is relatively safe and less complications.
• However, most common complications or side effects
of the silicon have seen that the skin of the nose is so
stretched , turning red and gradually thinner. That
can’t make the nose high as desire.
• At JW Korea Hospital, we have conducted to use
Megaderm material in rhinoplasty surgery for 1 year
with 160 customers.

5. Object selection
• The nose of patients have revealed the silicon inside
(A).
• Patients haven’t done rhinoplasty but the skin is very
thin (B). Patients with thin skin
• Patients with nasal skin are normal, but the desire to
have a high nose (C).
• Patients with a slender nose shape and thin skin, they
want rounded nose shapes ( D ). Low profile nasal
dorsum

6. Collected patient

7. Collected pateint

10. Techniques for Dorsal Augmentation

11. Tip plasty

12. Method of implementation:
• Using harvest of autogenous cartilages to build
columella nasi or replacing septal cartilage
with other materials indeed.
• The dorsal bridge of the nose is divided into 2
types:
- Using megaderm fully (I)
- Implant wrapped with Megaderm (II)

13. Tip plasty
•Cartilage graft: auricular cartilage, septal
cartilage, rib cartilage
•Application of nasal tip plasty: projection
•Correction for a blunt nasal tip long nose
•Short nose correction:
The main characteristics of Asian noses is short
and there is 70% in my servey is second
rhinoplasty so most of patient noses is short

14. Postoperative instruction after cartilage harvesting

15. Case 3 (Implant wrapped with Megaderm)

16. Case 2

17. Case 2 (implant wrapped with Megaderm)

20. Case 3 (Silicon implant wraped with Megaderm)

21. Result (1)
90 Cases
40 Cases
12 Cases
13 Cases
Table of research 1
• The nose of patients have
revealed the silicon inside
(A).
• Patients haven’t done
rhinoplasty but the skin is
very thin (B).
• Nasal dosal skin are normal,
but the desire to have a high
(C).
• A slender nose shape and
thin skin, they want rounded
nose shapes ( D )

22. Result (2)
•Total Megaderm
•Implant wrapped with
Megaderm
82%
18%
Table of Research
I II

23. COMPLICATIONS
Immediate complications
1. Implant deviation 2. Hematoma
3. Infection
Delayed complications
1. Thinned dorsal skin with visible implant contour
2. Redness of the dorsal skin
3. Capsular contracture resulting in upturned nasal tip or
visible implant contour on both sides
4. Delayed spontaneous hematoma
5. Implant extrusion through the tip skin or vestibular
mucosa

24. Result
• The average time of surgery is 1:30 , the shortest
cases need 1 hour and 3 hours for longest cases.
• The satisfaction is evaluated and based on the nose
shape recovering after 1 month, 3 months & 6
months.
• Complications and side effects:
• 01 case infection, the rate was 1/160.
• 03 cases need to be adjusted the deviation of silicon,
occuring to Megaderm wrapped with silicon implant

25. Conclusions
• In my servey, we can see that Megaderm could be the
solution for replacing silicon implant if the bridge of
the nose gets seriously redness and thin with the risk
of revealing.
• This method is able to make the dorsal nose higher
and even safer than silicon implant.
• The research has just been performed for one year so
we need the more time to evaluate more for the best
results.