眶隔脂肪瓣矫正下眼睑眼袋合并泪沟及睑颊沟凹陷畸形的效果

Efficacy of orbital fat pedicle on correcting eyebags with tear trough and palpebromalar groove deformity

目的探讨眶隔脂肪瓣矫正下眼睑眼袋合并泪沟及睑颊沟凹陷畸形的经验。方法2020年2月至2021年5月,中国医学科学院整形外科医院面颈部整形一中心用眼袋修复术联合眶隔脂肪释放术治疗35例眼袋合并泪沟及睑颊沟凹陷畸形患者,男4例、女31例,年龄35~63岁,平均47.5岁。患者均存在不同程度下眼睑皮肤松弛、眶隔脂肪膨出、中重度泪沟和睑颊沟凹陷畸形及骨性眶缘轮廓感;均用经皮肤切口眼袋修复术,将眶隔脂肪释放后向下牵拉并内固定于合适位置,填充泪沟及睑颊沟。结果35例患者手术伤口均一期愈合,术后无血肿、感染,切口愈合良好。术后随访时间3~18个月,平均8.6个月。35例患者眼袋、泪沟及睑颊沟畸形明显改善。术后1个月内,2例患者单侧仍然存在轻度脂肪膨出眼袋畸形,2例患者术后早期出现轻度下睑外翻,均未处理,3个月后恢复。结论眼袋修复术联合眶隔脂肪释放的手术方式,可有效修复下眼睑眼袋及矫正泪沟和睑颊沟凹陷畸形。

Objective To investigate the clinical experience of using orbital fat pedicle to correct eyebags with the tear trough and palpebromalar groove deformity.Methods From February 2020 to May 2021,35 patients with lower blepharoplasty combined with orbital fat-release were treated in the Facial and Neck Plastic Surgery Center of the Plastic Surgery Hospital of Chinese Academy of Medical Sciences,including 4 males and 31 females.Their age ranged from 35 to 63 years,with an average age of 47.5 years.Different degrees of lower eyelid skin laxity,orbital fat herniation,moderate and severe tear trough,palpebromalar groove deformity were observed in all patients.Preoperative examination showed no symptoms such as lower eyelid ectropion and lower eyelid retreat ment.All 35 patients were treated with transcutaneous incision blepharoplasty,in which the orbital septal fat was released,pulled downward and internally fixed to the appropriate position to fill the tear trough and palpebromalar groove.Results All patients obtained primary healing,no complications such as hematoma,and infection occured.Postoperative follow-up lasted from 3 to 18 months,with an average of 8.6 months.35 patients′eye bags with tear trough and palpebromalar groove deformity were obviously alleviated.Unilateral mild eye bag remained in 2 patients in postoperative 1 month,and 2 cases appeared mild lower eyelid ectropion postoperatively,none of these patients received special treatment and recovered after 3 months.Conclusions Lower blepharoplasty combined with orbital fat release can effectively repair eye bags and correct tear trough and palpebromalar groove deformity.