上睑提肌腱膜折叠矫正上睑下垂术后的中面部美学比例改变分析

The aesthetic analysis of midface ratio after folding aponeurosis of levator palpebrae superioris muscle in the ptosis correction

目的测量接受过上睑提肌折叠的重睑术患者眉上缘至下睑缘的距离(L1)和下睑缘至鼻下缘的距离(L2)之比,分析术前术后中面部美学比例的改变。方法收集我科2015年12月至2016年10月21例接受该手术患者术前术后照片,设为研究组。利用Adobe Photoshop测量术前术后L1和L2之比J。另收集20例中国地区女明星正面照片,设为对照组,同法测量J值,分析两组统计学差异。结果研究组中术前J1值平均为0.746,术后J2为0.657,对照组J3为0.667,研究组术前术后J值及研究组术前与对照组J值差异具有统计学意义。研究组术后和对照组J值差异无统计学意义。研究组术后L1/L2的比值接近对照组比值,更接近符合黄金分割的美学比例。结论术后患者L1缩短,和L2之比更符合黄金分割的美学比例,中面部美学比例更加和谐。对于此类患者的手术沟通及预期效果评估,也可以从中面部美学比例改变的角度进行分析。

Objective To measure the ratio of the length between upper edge of eyebrow and edge oflower eyelid（L1）/the length between edge of lower eyelid and nasal base（L2）in the fordless-eyelid and upper lidptosis patients who received levator aponeurosis folding surgery. To analyze the change in the proportion of midfa-cial aesthetics. Methods From December 2015 to October 2016,a total of 21 patients were recruited as studygroup. Those patientswere diagnosed with foldless eyelid and upper lid ptosis. They received levator aponeurosisfolding procedures were carried out in our departmentand the pre-and post-operative photographs were collected.Full-face pictures of 20 Chinese female movie stars were prepared as control group. The ratiosof L1/L2（J）weremeasured via Adobe Photoshop CS6. The statistical significance was analyzed and the change of midfacial propor-tion was evaluated. Results In study group,the mean value of pre-and post-operative L1/L2（J1）is 0.746 and（J2）0.657 postoperatively. In control group,the mean value of L1/L2（J3）is 0.667. Statistical differences showedbetween the pre-and post-operative samples and between pre-operative samples and control group. There was nostatistical difference between post-operative and control group samples. The ratios between L1 and L2 in post-opera-tive samples are close to those in control group,which are closer to the golden radio. Conclusions Levatoraponeurosis folding can effectively lower eyebrow in patients with upper lid ptosis and shorten the length betweeneyebrow and lower eyelid. Therefore harvesting a more appropriate and harmonious ratio of L1/L2 according the golden section theory. The changes in the proportion of midfacial aesthetics after operation could be used as a keypoint in the pre-operative communication and post-operative effect evaluation,besides the size of palpebral fissureand corneal exposure rate.