眶周联合悬吊除皱术改善中面部老化的临床应用

Clinical application of suspension of ocular orbicularis combined with rhytidectomy in the treatment of moderate and severe mid-face ageing

目的寻求一种简单、有效的联合术式,一次性去除眶周皱纹并调整眉形,改善中面部的衰老。方法采用眉上、下缘切口,切除上睑多余松弛的皮肤,并视外眦角下垂程度及眼角鱼尾纹多少,确定眼轮匝肌悬吊固定位置并行骨膜悬吊。下睑缘按设计线切开,行眼袋切除术,加固眶隔,并将眼轮匝肌行两点悬吊固定于骨膜上,以收紧眶区及中面部。结果术后随访65例6个月～3年,眉外形自然美观无下垂,眶周皱纹明显减少或消失,下垂鼻唇沟纹变浅,63例中面部松垂衰老得到明显改善。结论采用眉缘切口上睑除皱术与眼袋整复术联合并辅以骨膜悬吊除皱,可一次性去除眶周皱纹,迅速达到眶周及中面部年轻化的效果,避免单一手术后的不协调,除皱效果显著。

Objective To find a simple but effective integrated operation for the removal of peri-orbita rhytides, adjustment of semilunar and then improvement of midface aging. Methods Spilth dermal tissues of superior eyelids were resected with the incision of upper and lower superciliary margins. The suspension and fixed position of ocular orbicularis were determined by the severity of external canthi angulus ptosis and canthus fishtail linesand then they were suspended on periosteum. Eye haustras were reeised, orbital septums were strengthened and two points of ocular orbicularis were suspended on periosteum to astrict regio orbitalis and midface with a ineisional design line of the inferior margo palpebrae. Results The natural and artistic superciliary contours without ptosis, the diminution and even disappearance of canthus fishtail lines, the shoaling of pendulous nasolabial furrow wrinkles, and the relatively dramatic improvement of ptosis and senility on midface were found by postoperative follow-up from 6 months to 3 years. Conclusions The combination of superior palpebral rhytideetomy by the incision of superciliary margins, with auxiliary suspension of ocular orbieularis on periosteum and lower blepharoplasty removes wrinkles remarkably with result of one time removal of peri-orbita rhytides, rejuvenation of midface and peri-orbital skins, and avoidance of postoperative incoordination by a single operative procedure.