上睑松弛矫正同期行眉间降肌部分切除、自体真皮填充治疗眉间纹

One-stage correction of upper eyelid laxity and glabella wrinkle with partial removal of interbrow depressor muscles and filling by autologous dermis

目的探讨上睑松弛矫正同期行眉间降肌部分切除、自体真皮填充治疗眉间纹的效果。方法回顾性分析南京市第二医院整形外科2018年1月至2021年1月收治的上睑皮肤松弛伴有明显眉间动、静态皱纹的患者临床资料。手术通过眉下切口或重睑术矫正上睑松弛,同期行眉间降肌(皱眉肌、降眉肌、降眉间肌、内侧眼轮匝肌)部分切除,将切除的上睑皮肤组织去表皮制成真皮条或真皮块,填充于眉间真皮下矫正眉间纹。术后对患者眉间皱纹动、静态改善效果及相关并发症进行随访观察。结果共纳入16例患者,男2例,女14例,年龄37~57岁,平均47.3岁。术后患者切口均一期愈合,无血肿及感染等并发症。随访4~13个月,上睑皮肤松弛均得到较好的矫正,眉间动、静态纹均获得不同程度的改善,患者对效果均较满意。其中1例患者术后眉间有针眼样凹陷性瘢痕,未予处理;1例眉间有轻微隆起,术后6个月予局部注射复方倍他米松注射液后改善;2例眉间轻度低平,未予处理;2例额眉间皮肤感觉麻木,在3个月后逐渐自行改善。结论上睑松弛矫正同期切除部分眉间降肌,并以自体真皮填充眉间纹,可有效改善眼周老化。

Objective To evaluate the therapeutic effect of one-stage correction of upper eyelid laxity and glabella wrinkle with partial removal of interbrow depressor muscles and filling by autologous dermis.Methods The clinical data of patients with upper eyelid skin laxity accompanied by prominent dynamic and static glabella wrinkle admitted to the Department of Plastic Surgery,Second Hospital of Nanjing from January 2018 to January 2021 were analyzed retrospectively.The upper eyelid was corrected with under-eyebrow incision or upper eyelid blepharoplasty.The resected skin from laxity was trimmed as autologous dermis for filling of glabellar wrinkle.Meanwhile,the descending brow muscle was also partially resected.All patients were followed up to observe the improvement of dynamic and static glabella wrinkles and related complications.Results There were 16 cases,including 2 male cases and 14 female cases,aged from 37 to 57 years(mean 47.3 years).Primary healing was achieved in all cases without any hematoma and infection.Follow-up period lasted for 4-13 months.The upper eyelid laxity was corrected with improvement of dynamic and static glabella wrinkle.The patients were satisfied.Needle-like depressed scar happened in one case with no treatment.1 case had slight prominent tissue between the eyebrows,which was improved by local injection of compound Betamethasone injection 6 months after operation.2 cases had mild hypoplasia between the eyebrows without treatment.2 cases had numbness,which was relieved spontaneously after 3 months.Conclusions One-stage correction of upper eyelid laxity and glabella wrinkle with partial removal of interbrow depressor muscles and filling by autologous dermis can effectively improve periocular aging.