Tại sao Alloderm được thêm vào chất liệu cấy ghép tái tạo cằm ?
H PLASTIC SURGERY
[{'start': '3.900', 'end': '10.120', 'text': '[Music]'}, {'start': '8.120', 'end': '12.519', 'text': 'When I first started this job, I'}, {'start': '10.120', 'end': '15.519', 'text': "took a city photo of someone who didn't have a square jaw, and they"}, {'start': '12.519', 'end': '18.960', 'text': 'had masseter muscles like this.'}, {'start': '15.519', 'end': '21.080', 'text': 'This person had reconstructive surgery, but the masseter muscle did come down,'}, {'start': '18.960', 'end': '22.760', 'text': 'but'}, {'start': '21.080', 'end': '25.920', 'text': 'not completely.'}, {'start': '22.760', 'end': '28.279', 'text': 'So, even though I had a little surgery on the lower part, the'}, {'start': '25.920', 'end': '30.199', 'text': "angles weren't clear and I"}, {'start': '28.279', 'end': '32.279', 'text': 'felt like it was lacking.'}, {'start': '30.199', 'end': '34.920', 'text': 'I think this was about 6 years ago.  7 years ago.'}, {'start': '32.279', 'end': '37.760', 'text': 'Yeah, I think so.  So, when I'}, {'start': '34.920', 'end': '40.440', 'text': 'saw this and thought, "Oh, I'}, {'start': '37.760', 'end': '42.640', 'text': 'made this part clearer, but the angle was'}, {'start': '40.440', 'end': '45.160', 'text': 'not sharp enough, so I thought about why this part wasn\'t sharp enough," and it turned'}, {'start': '42.640', 'end': '48.360', 'text': 'out to be because of the muscles.'}, {'start': '45.160', 'end': '50.920', 'text': 'So, it would be nice to lower the muscle, but since'}, {'start': '48.360', 'end': '53.399', 'text': 'that is not possible, realistically, the muscle does'}, {'start': '50.920', 'end': '55.719', 'text': 'come down a little bit through surgery, but it does not'}, {'start': '53.399', 'end': '58.680', 'text': 'come down as a lump, but rather in a thin, spread-out form'}, {'start': '55.719', 'end': '61.239', 'text': '.  Now that I have that thought, I'}, {'start': '58.680', 'end': '63.680', 'text': 'took a CT scan and found that there'}, {'start': '61.239', 'end': '65.880', 'text': "are muscles like this.  So, wouldn't it be possible to create"}, {'start': '63.680', 'end': '67.600', 'text': 'angles with titanium prosthetics on these existing muscles,'}, {'start': '65.880', 'end': '69.479', 'text': 'drill holes'}, {'start': '67.600', 'end': '71.799', 'text': 'through them, and tie all of these muscles together'}, {'start': '69.479', 'end': '73.880', 'text': '?  So I thought about it that way and went'}, {'start': '71.799', 'end': '77.920', 'text': 'ahead with the surgery.  So the surgery was'}, {'start': '73.880', 'end': '80.600', 'text': 'done like this. The muscles were a little difficult, but they'}, {'start': '77.920', 'end': '83.159', 'text': 'pulled several needles into the muscles'}, {'start': '80.600', 'end': '85.400', 'text': '.  But this patient was a woman and her'}, {'start': '83.159', 'end': '88.400', 'text': 'muscles were not that thick, so I was'}, {'start': '85.400', 'end': '90.320', 'text': 'somewhat satisfied with it.  Even'}, {'start': '88.400', 'end': '92.479', 'text': "looking at it now, it doesn't seem that bad.   are you"}, {'start': '90.320', 'end': '95.600', 'text': 'okay.  But we did the same thing for a'}, {'start': '92.479', 'end': '97.360', 'text': 'man, and we'}, {'start': '97.360', 'end': '101.840', 'text': 'tried to lower the muscle by using titanium prostheses and tying the muscles like this, but the'}, {'start': '98.759', 'end': '104.399', 'text': 'problem'}, {'start': '101.840', 'end': '107.280', 'text': "was that the man's muscles were strong,"}, {'start': '104.399', 'end': '109.399', 'text': "so they didn't come down completely."}, {'start': '107.280', 'end': '112.399', 'text': 'So I'}, {'start': '109.399', 'end': '115.159', 'text': 'felt like it was a little bit less than the effect I was hoping for.  So'}, {'start': '112.399', 'end': '117.240', 'text': 'what we did after that was,'}, {'start': '115.159', 'end': '119.880', 'text': 'instead of titanium, we'}, {'start': '117.240', 'end': '120.799', 'text': 'made a bone cement treasure like this and added an artificial bone called Alloderm to'}, {'start': '119.880', 'end': '124.360', 'text': 'it to'}, {'start': '120.799', 'end': '126.960', 'text': 'add a little more volume to the missing volume. We have been'}, {'start': '126.960', 'end': '131.959', 'text': 'doing this surgery for over a year now.  So, by'}, {'start': '131.959', 'end': '137.280', 'text': 'attaching an artificial bone called Alloderm to the cement filling and'}, {'start': '135.239', 'end': '139.280', 'text': 'inserting it like this, we were able to create a shape where'}, {'start': '137.280', 'end': '141.840', 'text': 'this can fill in some of the volume in the areas where the muscle is lacking'}, {'start': '139.280', 'end': '144.319', 'text': '.  Titanium is'}, {'start': '141.840', 'end': '147.160', 'text': 'also'}, {'start': '144.319', 'end': '150.400', 'text': 'made in this way, and these days, surgeries are performed by adding artificial dermis to the dermis to'}, {'start': '147.160', 'end': '152.160', 'text': 'give it a little more volume'}, {'start': '150.400', 'end': '154.560', 'text': '.'}, {'start': '152.160', 'end': '156.920', 'text': 'So, since titanium'}, {'start': '154.560', 'end': '158.920', 'text': 'was made like this, I think those'}, {'start': '156.920', 'end': '160.320', 'text': 'parts have gotten a lot better'}, {'start': '158.920', 'end': '168.139', 'text': '.'}, {'start': '160.320', 'end': '168.139', 'text': '[Music]'}, {'start': '168.440', 'end': '171.440', 'text': 'A'}]