眼轮匝肌多点缝扎固定联合颞肌筋膜移植鱼尾纹除皱术

Rhytidectomy by multi-point suture of musculi dormitator with temporalis fascia graft

目的 探讨眼轮匝肌的多点缝扎固定联合颞肌筋膜移植隔离减轻或消除鱼尾纹的效果.方法 自2005～2009年,86例美容就医者接受了消除鱼尾纹的手术治疗,均为女性,平均年龄42岁.对外眦角部位的眼轮匝肌进行精细分离,露出完整和层次清晰的肌肉组织,通过对外缘眼轮匝肌向外上方的适度缝合悬吊,提升眼轮匝肌在上、下睑部以及外侧部的肌肉张力,也在一定程度上削弱了眼轮匝肌的收缩力度.对眼轮匝肌和深部组织多点缝扎固定,将眼轮匝肌的收缩力进行分解和中断,使其肌力不足以整体带动肌肉的长弧度的运动收缩.在手术涉及的组织完全愈合后,其肌力不足以牵动表面的皮肤产生皱褶和皱纹,鱼尾纹消失.结果 86例中获随访50例,随访3～28个月,效果明显持久,无血肿或神经损伤等严重并发症发生,受术者满意.2例出现1侧眉毛暂时性运动丧失,3个月后均自然恢复,1例出现真皮缝合后的皮下结节炎症,经过取出缝线后治愈.结论 采用眼轮匝肌多点缝扎固定和颞肌筋膜眼轮匝肌表面填充隔离,消除或减轻了鱼尾纹,手术简单可靠,组织创伤轻,恢复快,并发症少,受术者易接受,是一种值得推广的鱼尾纹除皱方法.

Objective The purpose of this study was to evaluate the efficacy of multipoint transfixion combined with filling of temporal fascia and the lateral orbicularis oculi muscle as an alternative rejuvenation technique on crow＇s feet wrinkles during face lift.Methods A retrospective review was conducted in 86 patients who underwent crow＇s feet wrinkles treatment during 2005 and 2009.During operation orbicularis＇ strength was broken down and blocked when we multi-pointly sutured and fixed the orbicularis oculi and deep tissue,temproal musculofascia was filled on the surface of multi-pointly sutured orbicularis oculi.By postoperative follow-up,complications,aesthetic outcome,and patient＇s satisfaction were recorded.Results In the group of 86 cases,50 cases were followed up from 3 to 28 months.The effect was lasting obviously and there was no any severe complications,such as hematoma or nerve injury.Patients were satisfied with their results.Among the total,2 patients appeared the temporary movement loss of the eyebrows in one side,but both recovered 3 months later.And 1 case appeared subcutaneous nodular inflammation and recovered after pulling out the suture.Conclusions The authors demonstrate that combination of filling with temporal fascia and the multipoint transfixion of lateral orbicularis oculi muscle is a safe technique,which may be a good alternative for periorbital rejuvenation and help in avoiding lower lid incisions or extensive dissections during face lifting in some cases.