除皱术解剖学研究及临床应用

Facial anatomic study and application in rhytidectomy

目的 以解剖学研究为基础寻找一种操作简单、安全、效果持久的除皱术式。方法 对 6具新鲜尸体进行头面颈部逐层解剖 ,观察鼻唇沟旁脂肪分布特点及皮肤限制韧带分布 ,结合临床观察对其功能进行评价。结果 面部老化时皮肤、皮下组织、SMAS均出现松弛 ,但松弛程度不同 ,各层组织需分别提升 ;鼻唇沟旁脂肪组织肥厚 ,有较大活动度 ,皮下分离不必超过咬肌前缘 ;面部老化后皮肤限制韧带变得松弛 ,只需双重折叠缝合面部SMAS便可矫正其松弛。临床应用局限性皮下分离 ,结合SMAS双重折叠缝合 ,进行 10 0例除皱术 ,效果满意 ,无严重并发症。结论 局限性皮下分离 ,结合SMAS双重折叠缝合的除皱术是一种简单、安全。

Objective To find a procedure for facial rejuvenation which is simple,safe with lasting aesthetic results basded on facial anatomic study. Methods Anatomy study was performed on 12 sides from 6 head specimens . Observe the range and thickness of fat lateral to the nasolabial grooves.Observed the location of the skin retaining ligaments and reappraised their functions combining with clinical observations. Results Skin and subcutis and SMAS (including mimic muscles) become slackening with aging, but the loosening degrees are different ,especially in the region lateral to the nasolabial groove. So they should be handled respectively. The fat lateral to the nasolabial groove is thick and is mobile with aging .So the subcutaneous detachment need not beyond the anterior border of the masseter. In the past two years, we performed rhytidectomy on 100 patients by limited subcutaneous detachment and SMAS double-plication. Satisfactory results were obtained. There are no serious complications observed. Conclusions Rhytidectomy by limited subcutaneous detachment and SMAS double-plication is a simple and safe procedure with lasting aesthetic results.;