自体脂肪游离移植修复泪槽畸形的临床体会

Application of autologous free fat graft for repair of tear trough deformity

目的探讨自体脂肪游离移植修复泪槽畸形的临床疗效及其应用体会。方法自2015年5月至2017年5月,对36例求美者行自体脂肪游离移植矫正泪槽畸形,于大腿根部内侧抽脂获得自体脂肪颗粒,采用反复静置、漂洗方式纯化自体脂肪颗粒,之后再采用双层医用纱布过滤去除纤维组织获得均匀纯净的自体脂肪颗粒,注射填充于泪槽凹陷部位皮下层及骨膜上层,骨膜上层采用超量10%~20%注射。结果 36例求美者经自体脂肪游离移植修复泪槽畸形,术后随访6~12个月,3例求美者经二次填充后达到满意效果,其余均为一次注射达到满意效果。术后均未出现感染、液化、血肿、色素沉着、硬结等并发症,泪槽畸形改善明显,轮廓饱满自然,效果满意。术后6个月,与术前对比修复效果并进行评价,求美者满意率为91. 7%,医师满意率为94. 4%。结论采用自体脂肪游离移植修复泪槽畸形,手术损伤较小、恢复快、并发症少,分层注射术后效果满意。

Objective To investigate the clinical effect and application of autologous free fat graft for repair of tear trough deformity.Methods A total of 36cases received autologous free fat graft for repair of tear trough deformity from May 2015 to May 2017.Autologous fat granules were obtained by liposuction on the inner side of thigh root and they were purified by repeated static and rinsing.After that,homogeneous and pure autologous fat granules were obtained by filtering fibrous tissue with double-layer medical gauze.The autologous fat granules were injected into the subcutaneous layer and the upper periosteum in depression of tear trough ,and the upper periosteum was filled with excess 10%to 20%injection.Results All cases were followed up for 6to 12months.There were 33cases achieved satisfactory results for first-time filler injection and 3cases achieved satisfactory results after a second-time filler injection.There were no complications such as infection, liquefaction,hematoma,pigmentation and sclerosis after operation.The tear trough deformity was improved obviously with natural outline,and the effect was satisfactory.Six months after operation,the repair effect was compared with that before operation and evaluated.The patient satisfaction rate was 91.7%,and the doctor satisfaction rate was 94.4%.Conclusion Autologous free fat graft has less injury,faster recovery and fewer complications in repair of tear trough deformity.The effect of stratified injection is satisfactory.