多平面分离联合除皱术

Combined facelifting by multiplane detachment

多平面分离联合除皱术的手术方法适用于年龄较大的、面部皱纹较多的病人。本组病人１０例，均为颅面骨体积减小，软组织明显移位，有明显的面中部和颈部软组织松弛下垂外观者，均行面中１／３骨膜下除皱，于眶外缘中部骨膜下分离颧弓前１／３和面中部；在耳前纵行切开腮腺咬肌筋膜，向前方游离之，并将此筋膜向后上方牵拉，切除多余部分缝合之；颈阔肌的后缘向后上方固定在胸锁乳突肌上，多余皮肤去除。结果证明，此手术方法可最大限度地复位表情肌和去除皮肤皱纹，尤其互补各种手术方法的不足，对额、鼻根部、鼻唇沟部、面中１／３、面下部和颈部皱纹去除均明显，使手术效果更为理想。

Purposed multiplane detachment and reposition operation was used to achieve satisfactory results in older persons with severe loosing of facial soft tissue.Method.This facelifting operation was performed in 10 cases (2 men and 8 women, age range 48-59 years) of midface and neck soft tissue loosing caused by senile bone shrinkage. The operative procedure was described by :subperiosteal facelifting operation of the central one third of the face; subperiosteal detachment of the zygomatic archs anterior one third and midface from the central part of the lateral orbital margin; forward freeing of fascia parotideomasseterica by preauricular vertical incision and then traction of the fascia posterosuperiorly, resection of the superfluous part and then suture; back-and up-ward fixation of posterior platysmal border to sternoclecdomastoid muscle and resection of the superfluous skin. Result. By advantages of combining several operation methods and their rational complementation,this operation method has substantially improved countenance muscles reposition and wrinkle-removing in forehead, nose root, nasolabial groove, central one third and lower face and neck. Conclusion. The study of this series of cases, in terms of, indications, complications and prevention, methods and feasibility , led the authors to consider these operation procedure,technique and program to have some advantages and being feasible.