摘要目的:介绍一种自体肋软骨与硅胶假体联合应用的鼻成形方法。方法:2014年6月至2018年3月，中国医学科学院整形外科医院整形外科就诊要求隆鼻的22例女性，年龄21～37岁，平均27.5岁。其中9例为自体肋软骨隆鼻术后鼻背移植物变形，拒绝再次用肋软骨；11例为人工材料隆鼻术后对鼻部外形不满意；2例为首次手术。在术中发现鼻背移植物厚度不足时，取一个L形硅胶鼻假体雕刻成合适的形状，衬于肋软骨移植物下，牢固缝合形成鼻背填充物复合体以垫高鼻背。结果:术后随访2～12个月，平均6.2个月。1例在术后第2天发现鼻小柱切口处血运不理想，切口处皮肤较苍白，考虑与切口张力较大有关，对局部皮瓣用胶条进行适当加压，第5天出院时皮肤颜色恢复。21例患者均恢复良好，形态满意， 无假体外露、感染等并发症，鼻背部无透光现象。结论:将硅胶假体与自体肋软骨联合移植可弥补软骨组织量不足，获得良好的美学效果。

abstractsObjective:To introduce a method of combining autologous rib graft and a silicone plate as a composite graft for augmentation rhinoplasty.Methods:Twenty-two female patients were included in this series. Eleven cases had unsatisfactory nasal appearance Nine cases were admitted for postoperative graft warping, and refused to harvest a second costal cartilage, thirteen cases had limited amount of rib graft for harvest. When cartilage was insufficient for a full dorsal onlay graft, a L-shaped silicone nasal implant would be used and carved into a plate-like, so as to make into a composite graft with the cartilage on top of the silicone plate.Results:Up to 12-month follow-up was conducted, averaged 6.2 months. One case exhibited temporary ischemic signs at the incisions, resolved by compressive taping at day 5.For all other 21 cases aesthetic outcomes were satisfactory with no graft infection, extrusion or other complications. The dorsal only graft did not significantly transilluminate.Conclusions:Rib-silicone composite dorsal graft is an applicable and safe method in augmentation rhinoplasty surgeries, particularly when there is limited amount of cartilage available.