应用大块真皮脂肪复合组织游离移植矫正面部凹陷畸形

Large autoiogous free dermal-fat graft in treating facial depression

目的探讨应用大块真皮脂肪复合组织游离移植矫正面部凹陷畸形的手术方法及临床效果。方法自1992年3月至2012年10月根据面部凹陷的范围及深度，应用相应大小和厚度的大块游离真皮脂肪复合组织（体积30～64cm2），移植修复16例面部凹陷畸形，其中11例为进行性单侧颜面萎缩，1例为面横裂，其余4例为其他原因造成的面部凹陷畸形。结果16例中有15例经I期修复即获得较满意效果，1例因脂肪少量液化、边缘吸收等并发症，于术后8个月行Ⅱ期填充修复。术后随访1～25个月，所有随访患者面部凹陷畸形均得到显著改善，双侧面部接近对称。受区及供区切口均I期愈合，瘢痕隐蔽，未出现功能障碍。结论真皮脂肪复合组织移植安全、方便、经济，术后触感及形态接近自然，面部凹陷畸形均能得到较为满意的修复。

Objective To investigate the operative effect of large autologous dermis-fat graft for the treatment of facial depression. Methods From Mar 1992 to Oct 2012, 16 patients with facial de- pression deformities were treated with autologous free dermal fat graft, including 11 cases of hemifa- cial atrophy and 5 cases of other facial depressions. Results 17 dermal-fat grafts were used in 16 pa- tients, the volume of which ranged from 30 cm3 to 64 cm3. 15 grafts survived completely, and the oth- er two were treated with partial fat liquefaction postoperatively. Satisfactory results were achieved in 15 patients after one stage treatment. The other one underwent secondary filling operation 8 months postoperatively due to resorption. The patients were followed up for 1 month to 25 months. All 16 ca- ses showed almost symmetry outlook at last. The wounds at the donor sites and recipient sites were primarily healed with no functional morbidity. Conclusions Large free autologous dermal-fat grafting is effective and safe for facial contour augmentation. The procedure is affordable and easy-to-use. It can not only obtain symmetry of the face but also provide a more natural shape and feeling.