小切口多层次除皱术的临床应用

Multiple levels of undermining in facial lifting experience of 56 cases by minimal incision technique

目的探讨小切口多层次除皱术的临床应用范围和效果。方法 56例患者取颞部和额顶部小切口,应用皮下浅筋膜层,浅表肌腱膜系统(SMAS)层和骨膜下层分层剥离行除皱术。结果 56例患者术后满意,疗效良好,2例手术后小血肿,治疗后好转。结论对于轻、中度的中青年皮肤松垂患者,多采用面上中部皮下浅筋膜层和SMAS层两层平面除皱,可以达到较好效果;对于年老较重的患者,则需要增加骨膜下除皱,能有效改善鼻唇沟及眶颧颊皮肤皱纹。小切口多层次除皱术组织损伤小、恢复快、并发症少、除皱效果确切,是面部除皱行之有效的方法 。

Objective To analyze the indications and the clinlic effects of different operations with multiple levels of undermining in facial lifting by minimal incision technique.Methods A total of 56 cases of multiplane facial lifting were operated by minimal incision technique with or without subperiosteal facial lifting.Multiplane facial lifting included two superficial planes on the skin and superficial muscular aponeurotic system（SMAS）,and subperiosteal facial lifting on the upper and midface.Subperiosteal facial lifting included forehead,periobital,maxillary and zygomatic region.Three key sutures located above ear anterior antilobium and mastoidea region.Results Postoperative effects were good in most cases except two cases with small local hemotoma which developed no sequelae after the treatment.Conclusion The superficial lifting on the whole face of undermining subcutaneous midface lifting with SMAS is fit for mid-aged individuals,and subperiosteal facial lifting can improve a severe nasolabial fold deformity and reduce wrinkles on periobital,maxillary and zygomatic region.This mininmal incision technique does work effectively in face lifting with less surgical injury,fewer complications and shorter recovery time.