眶隔脂肪瓣重置在多种重睑术后畸形矫正中的应用

Effects of orbital septum fat redistribution on multiple malformation of upper eyelid after blepharoplasty

目的探讨重睑修复术中用眶隔脂肪瓣重置矫正术后上睑凹陷、重睑过宽、多重重睑等畸形的效果。方法2015年9月至2017年9月,北京医院整形外科修复合并多种畸形的重睑38例。重新设计重睑线及去皮量,松解上睑瘢痕粘连,暴露眶隔,将中央脂肪垫外侧延伸部分完全游离,形成以中间脂肪团为蒂的脂肪条,将其重置于上睑凹陷区或睑板上缘,余行重睑术。结果38例合并多种畸形重睑患者术后随访6~12个月,患者上睑形态均得到明显改善。38例患者重睑线高度、外形基本对称,重睑外观改善明显,患者满意度较高,均未再次修复。结论用眶隔脂肪瓣重置可有效修复合并多种畸形的重睑,可成为上睑成形术中重要的附加术式。

Objective The multiple malformation of upper eyelid,including the excessive width of fold line,sunken and/or multiple folded upper eyelid are the common complications after blepharoplasty.The aim of this study was to investigate the clinical effect of orbital septum fat redistribution on correcting these deformities.Methods From September 2015 to September 2017,38 patients with multiple malformations of upper eyelid were treated.The incision of upper eyelid and the excessive skin was designed and resected.After completely relieving the scar adhesion zones,we set the lateral orbital septum fat free and transposed it to the inner side of orbital septum or superior border of tarsus with suturing fixation.Then we routinely completed the double eyelid operation.Results Thirty-eight patients with multiple malformations of upper eyelid were treated successfully.The patients were followed up for 6 months to one year,and the results were totally satisfactory.The operation was not performed again.Conclusions The orbital septum fat redistribution can successfully correct the multiple malformation of upper eyelid.It should become a regular procedure in blepharoplasty.