直视下腱膜前脂肪内自体脂肪锐针注射填充矫正上睑凹陷

Sharp needle injection of autologous fat within preaponeurotic fat under direct vision in the correction of sunken upper eyelid

目的探讨直视下锐针注射法将自体脂肪移植填充于腱膜前脂肪来矫正上睑凹陷的临床效果。方法自2017年6月至2019年12月,首都医科大学附属北京友谊医院医学美容中心和首都医科大学附属北京世纪坛医院整形外科采用直视下自体脂肪颗粒锐针注射移植矫正上睑凹陷136例,分为重睑术后上睑凹陷组(103例)、老年性上睑凹陷组(33例),分析及评估术后效果。结果所有患者上睑凹陷均得到了矫正,外观较满意,形态较好,移植脂肪未出现团块及明显移位等情况。其中重睑术后上睑凹陷组有5例患者因术前上睑瘢痕粘连严重、腱膜前脂肪缺失较多,4例行二次修复手术,1例未行手术治疗。重睑术后上睑凹陷组满意度为86.4%,老年性上睑凹陷组满意度为90.9%。结论直视下腱膜前脂肪内自体脂肪锐针注射填充法可以精准矫正上睑凹陷,补充腱膜前脂肪,定位准确,填充量易于控制,移植脂肪颗粒成活良好。该方法适宜临床推广。

Objective To explore the application and efficacy of sharp needle injection of autologous fat within preaponeurotic fat under direct vision in the correction of sunken upper eyelid.Methods From June 2017 to December 2019,136 patients with sunken upper eyelid underwent sharp needle injection of autologous fat under direct vision in Beijing Friendship Hospital of Capital Medical University and Beijing Shijitan Hospital of Capital Medical University.Divided into the upper eyelid depression group(103 cases)after double eyelid surgery and the senile upper eyelid depression group(33 cases)to analyze and evaluate the postoperative effects.Results All sunken upper eyelid were corrected.The appearance was satisfactory and the morphology was good.No mass or obvious displacement was found in the transplanted fat.There were 5 patients in the upper eyelid depression group after double eyelid surgery due to severe upper eyelid scar adhesion and more preaponeurotic fat loss.Four cases underwent secondary repair surgery,and 1 case did not undergo surgery.The satisfaction rate of the upper eyelid depression group after double eyelid surgery was 86.4%,senile upper eyelid depression group was90.9%.Conclusion Application of sharp needle injection of autologous fat within preaponeurotic fat under direct vision can accurately correct the sunken upper eyelid and supply the preaponeurotic fat.This method has the advantages of accurate positioning,easy control of filling volume and good survival of transplanted fat particles.It should be considerable for clinical promotion.