面中部提升术联合脂肪移植在面部年轻化的效果

Clinical effect of mid-face lifting combined with autologous compound fat transplantation in facial rejuvenation

目的探讨面中部提升术联合复合脂肪移植在面部年轻化中的效果和安全性。方法2016年10月至2020年5月,解放军总医院第四医学中心烧伤整形医学部接诊面中部老化患者26例,男10例、女16例;年龄38~65(47±6)岁。术前标记双侧面部下垂组织、容量缺失部位、面部静态性皱纹范围。用颞部发际线缘切口,对面部表浅肌肉腱膜系统剥离、折叠及悬吊以提升面中部;行脂肪抽吸术并制备复合脂肪,其中结构脂肪注射于术前标记面部容量缺失部位,血管外基质成分凝胶注射至静态性皱纹真皮层。术后6个月和12个月,采用观察者全球审美改善量表和患者全球审美改善量表进行评分,统计术后并发症和患者满意度。结果术后6个月,26例患者面部老化均得到改善。术后12个月,14例(53.8%)患者面部老化较术前得到显著改善,8例(30.8%)患者中度改善,4例(15.4%)患者轻微改善;25例(96.0%)患者对术后效果表示满意。1例患者出现术后出血,1例患者出现术后瘢痕增生,其余患者无明显并发症。结论面中部提升术联合复合脂肪移植的方法在提升面部软组织同时补充面部缺失容量,改善面部静态性皱纹,综合性解决面中部老化问题,临床疗效确切、并发症少、安全可靠。

Objective To investigate the clinical effect and safety of mid-face lifting combined with compound fat transplantation in facial rejuvenation.Methods From October 2016 to May 2020,26 patients with mid-facial aging were enrolled,including 10 males and 16 females,with an average age of(47±6)years(38-65 years).The facial superficial musculoaponeurotic system was stripped,folded and suspended through the temporal hairline incision to lift the middle of the face.Liposuction was performed and compound fat was prepared,in which structural fat was injected into the area marked with loss of facial volume before operation,and extravascular matrix component gel was injected into the static wrinkle dermis.Six and 12 months after operation,the global aesthetic improvement scale of the observer and the global aesthetic improvement scale of the patient were scored,and the postoperative complications and patients'satisfaction were counted.Results At the end of 6 months,improvements in mid face were reported in all patients by blinded reviewers.12 months after operation,53.8%(14 cases)of patients had significant improvement in facial aging,30.8%(8 cases)had moderate improvement,and 15.4%(4 cases)had slight improvement;25 patients(96%)were satisfied with the postoperative results.Postoperative hemorrhage occurred in one patient,scar hyperplasia occurred in one patient,and no obvious complications occurred in the other patients.Conclusions The method of midface lifting combined with compound fat transplantation can improve the facial soft tissue and supplement the facial missing capacity,improve the static wrinkles of the face,and comprehensively solve the aging problem of midface.It has a definite clinical effect,fewer complications,and is safe and reliable.It has definite clinical effect with less complications.