除皱术同期和术后3个月行自体脂肪移植应用于面部年轻化的临床疗效对比研究

A comparative study of simultaneous and delayed autologous lipofilling with rhytidectomy in facial rejuvenation

目的探讨分析面部除皱术同期及术后3个月行自体脂肪移植用于面部年轻化的临床效果。方法2015年6月至2018年1月潍坊医学院整形外科医院收治行面部年轻化手术的患者117例,采用随机抽签法均分为A、B、C组。A组39例,男3例,女36例,年龄44~67岁,行单纯面部除皱手术;B组39例,男4例,女35例,年龄45~67岁,除皱术同期行自体脂肪移植;C组39例,男3例,女36例,年龄45~65岁,除皱术后3个月进行自体脂肪移植。对比3组患者脂肪移植后面部(鼻唇沟、口角部)凹陷改善情况、面部年轻化效果以及B、C 2组并发症的发生率。结果117例中,A组15例、B组12例、C组2例面部萎缩情况改善不明显,余88例均较术前明显改善,达到了面部年轻化效果。C组患者的并发症发生率(3/39,7.69%)较B组(14/39,35.90%)明显减少;C组患者的术后面部改善优良率(34/39,87.18%)较B组(25/39,64.10%)和A组(13/39,33.33%)显著增高;C组患者鼻唇沟及口角凹陷改善优良率(36/39,92.31%)较B组(25/39,64.10%)和A组(7/39,17.95%)显著增高(P<0.05)。结论除皱术后3个月再行脂肪移植,改善面部软组织萎缩、凹陷的效果优于同期行脂肪移植,且具长期性。

Objective To discuss and analyze the respective clinical effects of autologous fat filling for facial rejuvenation in the same period of three months after incisions.Methods From June 2015 to January 2018,117 patients with facial rejuvenation admitted to the Plastic Surgery Hospital of Weifang Medical College were randomly divided into A,B and C groups.Group A(39 cases,male 3 cases,female 36 cases,age 44-67 years old)received simple rhytidectomy.Group B(39 cases,male 4 cases,female 35 cases,age 45-67 years old)underwent rhytidectomy and autologous fat filling at the same time.Group C(39 cases,male 3 cases,female 36 cases,age 45-65 years old)received autologous fat filling 3 months after rhytidectomy.We compared the improvement of facial depression(nasolabial groove and mouth angle),the effect of facial rejuvenation after fat filling in three groups and the incidence of complications in group B and C.Results 15 cases in group A,12 cases in group B and 2 cases in group C had no obvious improvement in facial atrophy,the remaining 88 cases had obvious improvement compared with before operation,and achieved the effect of facial rejuvenation.The incidence of complications in group C(7.69%)was significantly lower than that in group B(35.90%),the excellent or good rate of facial improvement and the nasolabial groove and peri-oral depression improvement in group C(87.18%,92.31%)was significantly higher than that in group B(64.10%,64.10%)and group A(33.33%,17.95%)(P<0.05).Conclusions Comparative analysis of fat filling after 3 months of wrinkle removal to improve facial soft tissue atrophy and collapse is more obvious and more permanent in effect than fat filling,which is worthy of clinical promotion.