高位SMAS联合颧脂肪垫及眼轮匝肌悬吊在面中部除皱术中的应用

Application of high-level SMAS combined with malar fat pad and orbicularis oculi muscle suspension in middle face rhytidectomy

目的探讨一种相对微创的面中部除皱技术,并分析高位SMAS联合颧脂肪垫及眼轮匝肌提升对面中部老化的改善情况。方法对121例患者实施高位SMAS联合颧脂肪垫及眼轮匝肌悬吊,于颞部发际缘设计切口,在颧弓以上范围沿SMAS浅层剥离,将下垂的颧脂肪垫、SMAS和眼轮匝肌悬吊于颞深筋膜,去除多余的皮肤组织,使下垂的面部组织维持长期的提升效果。结果本组121例患者术后随访6周至1年,均取得了面中部年轻化的效果;术后恢复时间较短,未发生面神经损伤、面部皮下血肿、切口感染等并发症;手术切口瘢痕较隐蔽。结论高位SMAS及颧脂肪垫和眼轮匝肌的复位,是面中部年轻化的关键。皮下层的安全剥离避免了面神经分支的损伤。该方法对面中部除皱效果较显著,皮下分离安全,且具有简便、效果持久等优点。

Objective To introduce a relatively minimally invasive operative method of middle facial rhytidetomy and analyze the effect of high-level SMAS combined with malar fat pad and orbicularis oculi muscle suspension.Methods High-level SMAS combined with malar fat pad and orbicularis oculi muscle suspension was carried out in 121 patients.The incision was designed along the hair borderin the temporal region,and then stripped along with the superficial SMAS in the range above the zygomatic arch.Drooping malar fat pad,SMAS and orbicularis oculi muscle were suspended in the deep temporal fascia,and excess skin tissue was removed.In this way,thesagging facial tissue can maintain along-term lifting effect.Results One hundred and twenty-one patients were followed up from 6 weeks to 1 year.All of them achieved satisfactory clinical results.The recovery time was shortand no complications such as facial nerve injury,subcutaneous hematoma or infection occurred.The postoperative incision scar is not obvious.Conclusion Restoration of high SMAS,malar fat pad and orbicularis oculi muscle was the key in middle facial rejuvenation.Injury of the facial nerve branches was avoided through the safe dissection of the subcutaneous layer.This method was relatively simple,surgically,and produced a significant and lasting effect.