眶区年轻化策略——王韧带松解及提紧的睑袋整形术(待续)

The combination of releasing and sling of Wang's ligament (fascia ligament of orbital muscle) for lower eyelid ble-pharoplasty

目的研究眶区老化改变的动态解剖,下睑眶区筋膜韧带功能和睑袋手术方法的改进.方法通过尸体解剖和数千例睑袋手术的临床实践,阐明眶肌筋膜韧带(王韧带)的解剖,及其在睑袋手术中的应用;结合文献复习,对下睑眶区韧带的作用进行了比较性研究,并进行了下睑老化的分类和睑袋手术方法的改进.结果在眶区老化中,皮肤、皮下组织、肌肉的松弛较韧带的松弛明显.采用眶肌筋膜韧带(王韧带) 的松解、提紧是眶区年轻化的有效手段.眶肌筋膜韧带位于眼外眦韧带内下方,眼轮匝肌外侧1/3的深面.起于眼轮匝肌外1/3的深面,和下睑板外侧1/3下缘,止于上颌骨眶下缘的外下1/4骨膜,长约12～15 mm,宽约10～12 mm.眶肌筋膜韧带松解、提紧睑袋整形术,较其他手术方法更能提紧下睑松弛皮肤3～5 mm.不仅提紧了下睑皮肤,而且可提紧颧眶区松弛的组织.结论王韧带松解、提紧睑袋整形术,其方法创伤小,能够有效地矫正下睑松弛,使眶区达到年轻化的效果.

Objective To investigate the dynamic anatomical changes in the orbital areas of aging face, and the function of fascia ligaments in the orbital area, Also to study results of combination of releasing and sling of fascia ligament of orbital muscle （Wang＇s ligament） for lower eyelid blepharoplasty. Methods Through the cadaver anatomical study and clinical experiences with thousands procedures of lower eyelid blepharoplasty, we study the function of fascia ligament of orbital muscle （Wang＇s ligament） and other ligaments in lower eyelid, and the procedure of the combination of releasing and sling of Wang＇s ligament for lower eyelid blepharoplasty, and we also make classification of aging lower eyelid by personal experiences and literature review. Results The skin and muscle are much more laxative than the ligaments on orbital area of the aging face. When making combination of releasing and sling of Wang＇s ligament for lower eyelid blepharoplasty, it may lift 3--5 mm more loose skin of lower eyelid than other procedures. This procedure results are not only for the lower eyelid loose skin lifting but also the malar ptosis. The aging lower eyelid was dassified into four types. Conclusion It is a good choice for lower eyelid blepharoplasty to use the combination of releasing and sling of Wang＇s ligament and the patients may get minimal trauma and more obvious results.