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目的:探讨鼻部不明注射物对鼻背软组织及鼻整形的影响。方法:2018年7月至2019年7月，从大连大学附属新华医院整形外科信息系统数据库收集62例患者资料，有不明注射物隆鼻手术史患者28例，男1例、女27例，年龄28.8(19～53)岁，取出不明注射物同时实施鼻整形手术。另有34例初次接受鼻整形女性患者，年龄26.8(19～46)岁。通过镜下观察切除的鼻背注射物，分析不明注射物对鼻背软组织的影响；用统计学方法评估两组患者不满意率的差异。结果:28例不明注射物中，患者不明注射物中含有凝胶样注射物的组织呈粉红色胶冻状，颗粒样注射物呈鱼子状质韧不规则形状；其中，5例病理切片上可见肌肉组织，显示注射物注入邻近鼻背肌肉，切除注射物可导致鼻背肌肉不同程度受损；28例患者均接受了鼻整形手术，其中有11例女性患者对手术效果不满意。34例初次鼻整形手术患者中，有4例患者对手术效果不满意。初次鼻整形组不满意率11.76%(4/34)，不明注射物组不满意率为39.29%(11/28)，两组比较差异有统计学意义(χ 2＝6.34， P＝0.012)。 结论:鼻部不明注射物可能降低患者术后满意率，并对鼻背软组织和鼻整形造成不良影响。

Objective:To explore the impact of unidentified injectable fillers on the soft tissue of nasal dorsum and rhinoplasty.Methods:The Plastic Surgery Information System of Xinhua Hospital Affiliated with Dalian University was utilized to conduct an analysis of 62 rhinoplasty patients between 2018 and 2019. Specifically, this included 28 patients with an unidentified history of injectable filler rhinoplasty, encompassing 1 male and 27 females with ages ranging from 19 to 53 years and a mean age of 28.8 years. Additionally, 34 patients underwent primary rhinoplasty, all of whom were female with ages ranging from 19 to 46 years and a mean age of 26.8 years. This study examined the effects of unidentified injectable fillers on the soft tissue of the nasal dorsum by analyzing the excised nasal dorsum under a microscope. Subsequently, statistical methods were performed to assess differences in gender, age, preoperative tip protrusion/nose length, postoperative tip protrusion/nose length, dorsal augmentation modality, and satisfaction, and to investigate the effect of unidentified injectables on the rate of dissatisfaction after rhinoplasty.Results:The histopathological analysis of unidentified injectable fillers removed from the nasal dorsum revealed the presence of mainly gel and granular fillers. The gel fillers, characterized by its pink jelly-like texture, contained unidentified injectable fillers, colorless glue, and were observed to flow out upon cutting. The granular filler, on the other hand, appeared as tough, irregularly shaped tissue similar to caviar. Additionally, evidence of muscle tissue in 5 pathologic sections indicated that the unidentified injectable fillers were injected into or near the dorsal nasal muscles, leading to varying degrees of muscle injuries upon excision. A comparison of 28 rhinoplasty patients with unidentified injectable fillers for nasal dorsal augmentation and 34 patients with primary rhinoplasty showed that 11 females in the former group and 4 females in the latter group were dissatisfied with the results. Statistical analysis demonstrated no significant differences between the two groups in terms of gender ( P=0.452), age ( P=0.219), preoperative tip projection/nasal length ( P=0.681), postoperative tip projection/nasal length ( P=0.105), and nasal dorsum augmentation methods ( P=0.413). However, the initial rhinoplasty group had a lower dissatisfactory rate (4 cases, 11.76%) and the unidentified injectables group had a higher dissatisfactory rate (11 cases, 39.29%), which was statistically significant between the two groups (χ 2=6.341, P=0.012). Conclusions:The presence of unidentified nasal injectable fillers can significantly decrease postoperative satisfactory rates, increase the incidence of dissatisfaction, and have adverse effects on the soft tissues of the nasal dorsum and the overall outcome of the rhinoplasty procedure.