颌面轮廓手术联合微创隧道剥离提拉技术改善面部皮肤松垂的效果

Facial contouring surgery combined with the clinical application of minimally invasive tunnel separation and lifting technique

目的:探讨颌面轮廓手术同时改善面部皮肤松垂的方法。方法:2020年10月至2021年10月,四川友谊医院整形外科进行下颌角和颧骨手术患者50例,男6例、女44例,年龄30~43岁,平均37岁。均先行颌面轮廓手术,用特制的锥状套管剥离器向颧脂肪垫及咬肌韧带、耳前韧带处进行皮下隧道状剥离,经套管置入双向倒刺线垂直向上提拉,在耳后乳突上方穿出,剪除多余线头。结果:随访3~12个月,50例患者术后恢复良好,术后中下面部皮肤均得到不同程度的提升效果,颧脂肪垫得到提升,下颌轮廓线更加清晰,鼻唇沟较术前有显著改善。结论:面部轮廓手术同时用微创隧道剥离提拉技术可有效改善中下面部皮肤松垂,临床效果较好。

Objective To explore a simple and effective clinical method for improving facial sagging while performing maxillofacial contouring surgery.Methods From October 2020 to October 2021,50 patients with mandibular angle and malar surgery in the Plastic Surgery Department of Sichuan Friendship Hospital were selected,aged 30-43 years,with the average age of 37 years,including 44 females and 6 males.Maxillofacial contouring surgery was performed under transnasal intubation general anesthesia,the interorgual jaw groove incision was performed with a swing saw for bilateral long arc osteotomy,and the maxillary gingival groove incision and sideburn skin incision were performed for zygomatic osteotomy reduction and zygomatic arch incision.A small incision about 3 mm long was taken 1 cm from the edge of the temporal hair;a special conical cannula stripper was used to perform subcutaneous tunnel peeling to the zygomatic fat pad and masseter muscle ligament,anterior appendage ligament,then a two-way barb line was placed through the casing to lift vertically upwards,pierce above the posterior papillae of the ear,and the excess thread was cut off.Results Following-up for 3-12 months,all recipients recovered well after surgery,the skin of the middle and lower parts of the postoperative body was lifted to varying degrees,the cheek fat pad was lifted,the jaw contour line was clearer,and the nasolabial fold was significantly improved as compared with that before the operation.Conclusions At the same time as facial contouring surgery,the use of minimally invasive tunnel separation and lifting technique can effectively improve the skin sagging in the middle and lower parts,and it is simple and effective,and the clinical application effect is good.