应用双瓣法行下睑袋整形术：附26例报告

Blepharoplasty of lower eyelid with double-flap： a report on 26 cases

目的探讨皮瓣加肌皮瓣法（双瓣法）在下睑袋整形术中的应用效果。方法经皮肤入路行下睑成形术切口，采用皮瓣和肌瓣联合的方法，适当保留睑板前眼轮匝肌，在皮肤、眼轮匝肌表面和眼轮匝肌与眶隔之间进行剥离，直达眶下缘。术中采用Hamra’s法，沿眶下缘松解眶隔，释放眶隔脂肪，将其填充于眶下缘凹陷处，并设计下睑眼轮匝肌瓣，用以缩紧悬吊松弛下垂的下睑肌肉与皮肤，并适量去除皮肤。结果本组共26例患者，术后1例出现血肿，给予清除；1例因一侧眼轮匝肌瓣固定不牢致下睑退缩。其余患者术后均获随访6—18个月，效果满意。结论双瓣法下睑袋修复方法，既可有效矫正睑袋畸形，使下睑外观自然，符合美学要求，同时又可使面颊部得到提升，达到中面部年轻化的效果。

Objective To explore the effects of a double-flap （ skin flap and skin muscle flap） applied in blepharoplasty of lower eyelid. Methods Through a subcutaneous incision, the method of skin flap combined with skin muscle flap was adopted with appropriate musculus orbicularis oculi reservation, orbicularis oculi muscle was separated from skin and orbital septum till the lower orbital margin. The orbital septum fat was released by Hamra＇s method to fill the depression of infraorbital margin, then the orbicularis oculi muscle flap was designed to lift bagged the muscle and skin of lower eyelid and excessive skin was removed. Results After 6 to 18 months following up, 26 patients received satisfactory results except for one case with postoperative hematoma and the other one with lower eyelid retraction due to flabby reposition of the orbicularis oculi muscle flap. Conclusion The technique mentioned above could not only repair the baggy lower eyelid to meet aesthetical requests but also lift the cheek to achieve rejuvenate of the midface.