眼轮匝肌悬吊法睑袋成形术的改进

Release of orbicularis retaining ligament ： an improved method of orbicularis oculi muscle supension blepharoplasty

目的探讨在眼轮匝肌悬吊法睑袋成形术中，通过眼轮匝肌支持韧带完全松解，使附着在眶缘骨膜上松弛的皮肤、皮下组织得以充分释放，以达到下睑组织和眶颧组织整体提紧效果的改良手术方法。方法对409例具有较明显沟槽畸形的患者，在行眼轮匝肌悬吊法睑袋成形术过程中，增加了眼轮匝肌支持韧带离断、韧带断端上提与眶隔筋膜固定的操作，对眼轮匝肌悬吊法进行改进。结果经术后随访1～3年，全部受术者沟槽畸形改观明显，无1例出现并发症，得到比较满意的疗效。结论改良的眼轮匝肌悬吊法睑袋成形术。松解了眶颧部皮肤，有利于恢复睑颊复合体的平整自然，对改善沟槽畸形尤为有效。此法简单易行，安全性高，可作为下睑袋成形术的优选术式。

Objective To study a improved technique by releasing the orbicularis retaining ligament in orbicularis oculi muscle supension blepharoplasty. Release of the orbicularis retaining ligament could cut off the contact between orbitomatar skin and periosteum at inferior orbital rim, and carry the point of tightening orbitomalar skin in orbicularis oculi muscle supension blepharoplasty. Methods There were 409 patients with apparent orbitmalar fold. The methods of releasing orbicularis retaining ligament and orbital septum fixation were added to improve the orbicularis oculi muscle supension blepharoplasty. Results 409 cases were treated using this method over the past 3 years. All results were satisfactory. No complications were observed. Conclusion This improved method of orbicularis oeuli muscle supension blepharoplasty is useful for orbitomalar skin rolling, especially for orbitmalar fold. The release allows effective redraping and upward mobilization of the orbicularis of the lower lid and the premalar soft tissues. This method is a simple, safe and effective procedure for the correction of tear trough deformity and well-demarcated lid/cheek junction in lower eyelid belpharoplasty, h is one of the best choices for lower eyelid blepharoplasty.