侧向进针注射填充改善鼻唇沟过深的技术探讨

Improvement of nasolabial fold wrinkles with filler injection by lateral insertion of the needle

目的观察应用侧向进针注射填充改善鼻唇沟过深的临床效果和安全性。方法对鼻唇沟过深的168例（336侧）求美者，应用注射用修饰透明质酸钠凝胶（瑞蓝2号）进行填充矫正。在鼻唇沟外侧3～5／nm的平行线上，设定A、B、C点作为皮肤穿刺点。A点设为进针后到达鼻唇沟凹陷最明显处，偏向鼻唇沟内侧做扇形注射，注射层次为皮下深层与表情肌之间；之后，分别在其上下作B点和C点的扇形注射，最后在鼻唇沟内侧上唇部，鼻翼外侧垂线中上1／3处设定D点作为补充注射点。结果以注射后3个月作为效果评价时间，本组中，改善217侧（64．6％），明显改善95侧（28．3％），非常满意24侧（7．1％）。所有求美者，均无局部皮肤色泽、质地异常，局部感染和组织缺血、坏死等并发症发生。结论采用鼻唇沟外侧皮肤穿刺进针，定位方便，穿刺距离较短，疼痛较轻；矫正部位按严重程度进行，效果自然可控；穿刺方向不易发生血管内注射和栓塞，值得推荐应用。

Objective To assess safety and efficacy of filler injection in the correction of nasolabial folds with the lateral insertion of the needle. Methods From December 2009 to December 2012, totally 168 patients （336 sides） with overdeep nasolabial fold were filled with hyaluronic acids （HAs, Restylane）, A （the most deeper point）, B and C points on the parallel line 3 - 5 mm to the lateral of nasolabial fold were as the skin puncture points. The fan-shaped injection between deep layer of subcutaneous and mimetic muscles on the lateral of nasolabial fold from was performed firstly in Point A, and then the B and C points. The upper 1/3 point in perpendicular line of nasal ala lateral was as the supplemental point, the Point D. was injected into the area of NLF along its lateral at three separate points. It was expected that filler mostly extended in the layer between the deep dermal and expression muscle. Results The cosmetic results were evaluated at 3 months after the first filling procedure by surgeon and patients using the Wrinkle Severity Rating Scale （WSRS）. Of 168 pa- tients （336 sides）, 217 sides （64. 6% ） were improved, 95 sides （28.3%） were significant improved and 24 sides （7.1%） were satisfied. There were no complications, like local infection, ischemia, necrosis and abnormal color and texture occurring. Conclusion The procedure of lateral insertion of filler needle was recommended because of several advantages including easy puncture, less pain, short subcutaneou way, more accurate correction and less risk of artery occlusion.