眉部和下睑缘切口对颧脂肪垫及眼轮匝肌悬吊的中面部年轻化效果分析

河南外科学杂志 2017 年 3 月第 23 卷第 2 期HENAN JOURNAL OF SURGERY Mar. 2017，Vol. 23，No. 2? 27 ?

眉部和下睑缘切口对颧脂肪垫及眼轮匝肌悬吊的中面部

年轻化效果分析

齐遙

甘肃庆阳市人民医院整形美容科庆阳745000

【摘要】目的探讨眉部和下睑缘切口对颧脂肪垫及眼轮匝肌悬吊的中面部年轻化效果。方法以72例进行面中部整形者 为观察对象,应用眉部和下睑缘切口对颧脂肪垫及眼轮匝肌悬吊法进行手术。分析术后1周、3个月、6个月和1a的治疗效果，观察 有无外眦变形、下睑外翻或退缩、瘢痕增生等并发症。结果患者均未出现外眦变形、下睑外翻和面神经损伤并发症。4例患者下睑 外眦切口末端有少许猫耳,3 ~6个月后自行消失。2例术后1周时出现双侧鼻唇沟不对称，采用脂肪填充后被矫正。3例患者术后外 眦水肿较明显，经射频治疗后逐渐恢复。3例患者早期诉眼部干涩，3个月后症状消失。其余患者效果满意，中面部老化状态得到良 好矫正，且无其他并发症和继发畸形出现。结论眉部和下睑缘切口对颧脂肪垫和眼轮匝肌悬吊处理效果满意，手术切口小且无面 神经损伤，有效提高中面部的年轻化美容效果。

【关键词】下睑缘;颧脂肪垫;眼轮匝肌悬吊术;面部年轻化

【中图分类号】R622【文献标识码】B【文章编号】1077 -8991(2017)02 -0013 -02

Analysis of facial rejuvenation effect of eyebrow and subciliary of malar fat pad and orbicularis muscle suspension Qi Lei. Department of p lastic and cosmetic surgery, Qingyang People's Hospital, Gansu, Qingyang 745000, China

【Abstract】Objective To investigate the eyebrow and subciliary incision on the malar fat pad and orbicularis muscle suspension in fa-cial rejuvenation effect. Methods To observe the 72 cases of central plastic surgery in our hospital, method and application of eyebrow subcili-ary of malar fat pad and orbicularis muscle suspension surgery, the postoperative results were followed up for 1week, 3 months, 6 months and 1year after operation, there is no lateral deformation observation, Complications such as lower eyelid retraction or withdrawal, scar hyperplasia, Evaluate the effect of surgery. Results The lateral deformation, ectropion of lower eyelid and facial nerve injury and there were no complica-tions in all patients. 4 cases of patients with lower eyelid incision at the end of a band of ears, 3 to 6 months disappear. There were 2 cases of bilateral cleft lip and cleft lip in one week after operation. 3 cases of patients with postoperative external canthus obvious edema and gradually recovered by radiofrequency ablation. 3 cases of patients with early complaints of dry eye, the symptom disappeared after 3 months. The rest of the patients with satisfactory results, the state of the aging of the face was well corrected, and no other complications and secondary deformities. Conclusion Eyebrow and subciliary incision of malar fat pad and orbicularis muscle suspension with satisfactory effect, small incision and no facial nerve injury, effectively improve the cosmetic effect in the face of the young.

[Key words] Subciliary; Malar fat pad; Orbicularis muscle suspension; Facial rejuvenation

由于睑-颊交界下垂、软组织松垂且容积减少，常 导致眼裂和口裂之间的中面部老化垂直下移松弛[1]。传统术式如SMAS常达不到预期的年轻化效果，而复合 的除皱术损伤大、恢复时间长且易引起并发症[2]。2014 -01 —2015 -08间，我们选取72例面中部整形 者，应用眉部和下睑缘切口对颧脂肪垫及眼轮匝肌悬吊 的整形技术，效果满意，报告如下。

1资料与方法

1.1 一般资料本组72例面中部整形者中，男6例、女66例;年龄（48. 32 ±5. 71)岁。均表现为不同程度 的上睑和下睑皮肤松垂，外舭下垂，下睑疏松低垂呈袋 状[3]，颊部下垂且鼻唇沟加深等。符合第4版《面部年 轻术》中相应手术的诊断标准。C T检查结果排除其他 原因引起的面部疾病。1.2方法（1)术前准备:询问有无高血压、糖尿病等 慢性病的病史及用药史和整容手术史[4]。进行血常 规、凝血、生化检查并测量血压，除外严重高血压及血糖 控制不佳者。服用抗凝药者应于术前一周停药。检查 并评估颊部下垂的明显程度，眉、上睑及外舭皮肤的松 垂程度，眶脂肪的丰富程度和眼轮匝肌肌力，以及泪槽 沟、睑颊沟、鼻唇沟是否明显。（2)手术方法:患者取坐 位，手术医生根据患者面部轮廓与其进行沟通，设计满 意眉形，然后标记切口位置。距眉头1〇 mm处作为梭 形切口的内侧，距眉尾外5 mm处作为切口外侧，使切 口与眉部下垂程度相适应。嘱患者平视前方，上抬眉 部，观察其皮肤上提量并据此评估切除的松弛皮肤量。下睑缘切口内侧为距下睑睫毛1?2 m m的泪小点下 方，顺眼部平行外舭适度延伸直至外舭，然后沿鱼尾纹