眶隔脂肪中央团重置矫正上睑凹陷重睑术效果

Correction of sunken upper eyelids with central orbital fat transposition during upper blepharoplasty

目的探讨眶隔脂肪中央团重置矫正上睑凹陷重睑术的有效性和可行性。方法2016年1月至2020年6月,天津伊美尔整形美容医院和武警特色医学中心整形外科对上睑凹陷施行重睑手术患者58例(男14例,女44例,年龄16〜42岁,平均29.3岁),在术中将眶隔脂肪中央团外展部进行游离,反转180°展平,缝合到内侧眶隔脂肪团。将术前和术后6个月患者照片进行比较,观察上睑形态,上睑凹陷矫正的效果。58例患者中52例术后6个月随访,对术后满意度进行评分。结果52例患者中41例对手术结果满意和非常满意,患者上睑饱满,重睑线流畅,上睑外侧臃肿外观得到改善;11例患者对手术结果满意度一般。术前上睑凹陷(4.9±1.1)mm,术后凹陷(2.4±0.7)mm,两者相比差异有统计学意义(P<0.05)。结论重睑术中用眶隔脂肪中央团重置技术可矫正上睑凹陷,使术后上睑形态饱满,重睑流畅,值得临床应用。

Objective To evaluate the effectiveness of correction of sunken upper eyelid with central orbital fat transposition during upper blepharoplasty.Methods We performed 58 cases of upper blepharoplasty with sunken upper eyelids during January 2016 and June 2020.The lateral portion of the central orbital fat was dissected and reversed 180 degrees,and then fixed to the medial fat pad.Photographs before and 6 months post-operatively were measured to determine the degree of the upper eyelid depression.The results were compared statistically.At the consultation 6 months postopera-tively,the patients were asked to evaluate the results of the operation using the Clients Satisfying Questionnaire,with the grade between 4(very satisfactory)and 0(very dissatisfactory).Results Sunken eyelids were effectively corrected in 41 of the 52 patients,but 11 patients had minimal effect because of the lack of sufficient central fat volume mostly due to the prior blepharoplasty.At 6 months post-operatively,52 of the 58 patients finished the satisfaction questionnaire.Forty one of the 52 patients were satisfying with the results.The mean score was 3.3±0.73.The degree of the upper eyelid depression was(4.9±1.1)mm preoperatively and(2.4±0.7)mm postoperatively.There was a statistically significant difference(P<0.05).Conclusions The central orbital fat transposition is an effective way to correct the sunken upper eyelids during the upper blepharoplasty.The results are satisfactory with full upper eyelids and smooth double eyelids.