眶隔脂肪瓣转位联合下垂组织复位在中面部年轻化中的应用

Application of orbital fat flap transposition combined with sagging tissue reposition in mid-face rejuvenation

目的探讨经下睑缘切口,眶隔脂肪瓣转位联合下垂组织复位术在中面部年轻化中的应用效果。方法自2018年1月至2020年5月,美缔医疗美容门诊部对收治的46例睑袋伴睑颊沟凹陷及中面部软组织下垂患者采用下睑缘切口,剪开眼轮匝肌,打开眶隔膜形成眶隔脂肪瓣,继续向下分离至"法令纹"上缘水平,打开上颌前间隙及颧前间隙,使间隙相通,将眶隔脂肪瓣在间隙内平铺,再覆盖眼轮匝肌-颧脂肪垫复合体,均固定于眶下缘,将眼轮匝肌向外上悬吊于眶外缘骨膜及其周围坚韧的组织。结果 46例患者获随访3~19个月,切口均一期愈合,睑袋及睑颊沟凹陷、鼻唇沟皱褶均得到明显改善,中面部下垂组织均得到复位,效果满意。无下睑退缩、睑外翻、感染等并发症发生。结论采用眶隔脂肪瓣转位联合下垂组织复位的手术方法,可使中面部明显年轻化。该方法创伤较小、出血较少、效果可靠、方法简单且易于推广。

Objective To discuss the efficacy oforbital fat flap transposition combined with sagging tissue reposition through the lower eyelid margin incision in mid-face rejuvenation. Methods From January 2018 to May 2020, 46 patients with lower eyelid pouches,eyelid-cheek junction depression and sagging tissue of mid-face were collected in Meidi Medical Cosmetology Outpatient Department.Through the lower eyelid margin incision, the orbicularis oculi muscle was separated and orbital septum was exposed. The orbital septum was opened to form the orbital septal fat flap. We continued to detach down to the level of upper margin of the nasolabial fold, open the anterior maxillary space and make the zygomatic space to communicate with the space. The orbital septal fat flap was tiled in the space and then covered with orbicularis oculi muscle-zygomatic fat pad complex, which were fixed on the lower orbital margin. The orbicularis oculi muscle was suspended outwards and upwards to the periosteum of orbital edge and tough tissue around it. Results All 46 patients were followed up for 3 to 19 months, and all incisions were primary healing. The eyelid pouch, depression of eyelid-cheek junction and nasolabial fold were significantly improved. The sagging tissue of mid-face was restored. The postoperative results were satisfactory. No complications such as lower eyelid retraction, ectropion and infection were found. Conclusion The orbital fat flap transposition combined with sagging tissue reposition can significantly rejuvenate the mid-face. This method has the advantages of less trauma, less bleeding, reliable efficacy, simple method and easy to popularize.