双矢量小切口(短瘢痕)面部提升术

Minimal Incision Rhytidectomy(Short Scar Face Lift)with Double Vector

目的:寻找一种安全可靠、操作简单、恢复快捷、切口短小、效果持久的面部提升手术方法。方法:选择2019年1月-2021年12月就诊的47例就医者为研究对象,通过综合经典小切口(短瘢痕)和颞部小切口的术式,应用皮下、表浅肌肉腱膜系统(Superfacial Musculo Apponurotic System,SMAS)、SMAS下平面(sub-SMAS)以及骨平面等层面,在眶颧、眶下、梨状孔、颧肌、面颊、下颌缘及颈阔肌等部位,松解释放包括颧韧带、眶韧带、眼轮匝肌下限制韧带、颧骨皮韧带、颊上颌韧带、腮腺咬肌韧带、颈阔肌限制韧带等,通过单叶或双叶SMAS瓣悬吊、限制性叠瓦状固定、可吸收拉提带双平面拉提等方法,对面部组织进行外上和垂直双矢量强力提升,达到全方位面部年轻化的效果。结果:该方法对面部衰老发生原理、老化病损的症状和表现进行针对性的处理,47例就医者面部松垂的典型表现如眉眼周围松垂、颧脂肪垫位置下移、睑颊沟鼻唇沟加深、颊部松垂、“羊腮”显现、下颌缘臃肿不清晰、颈部松弛等均有不同程度地改善,达到了面部提升的效果。结论:双矢量小切口面部提升术通过经典小切口或短瘢痕术式有限操作空间进行操作,实现瘢痕最小化的效果;加用颞部小切口,通过骨膜层面安全便捷的完成延展性面部提升的预期和操作,规避了手术的风险;应用SMAS瓣垂直矢量提升和叠瓦状外上矢量提紧固定,真正意义上实现垂直矢量强化组织下垂的有效的提升、外上矢量加强面部松弛的自然紧致效果,达到双矢量面部提升的目的。

Objective To find a new reliable facial lifting technique with simple operation,quick recovery,minimal incision and lasting effect.Methods 47 patients who visited the hospital from January 2019 to December 2021 were selected as the research objects,the new technique combines typical short scar face lifting with small temporal incision operation.The anatomical levels are including Superfacial Musculo Apponurotic System(SMAS),sub-SMAS and bone plane.In orbital zygomatic,infraorbital,piriform foramen,around the zygomatic muscle,cheek,mandibular margin,platysma,and other parts,releasing ligaments include zygomatic ligament,orbital ligament,circumscribed ligament under orbicularis oculi muscle,zygomatic skin ligament,buccal maxillary ligament,parotid masseter ligament,circumscribed ligament of the platysma muscle,etc.The methods conclude single or double leaf SMAS fl ap suspending,restrictive imbricate fi xation,absorbable lifting belt,biplane lift,etc.Results This new technique could eff ectively deal with the principle of facial aging and the expression of aging lesions.The typical characteristic(ptosis of eyebrows and eyes,the downward movement of the zygomatic fat pad,the deepening of the eyelid buccal groove and nasolabial groove,the sagging of the cheeks,sheep gills,indistinct mandibular margin,and the relaxed neck)in 47 patients were improved and achieved the facial rejuvenated result.Conclusion Double vector small incision face lift can be operated through the limited operation space of typical small incision or short scar to achieve the eff ect of scar minimization.With small temporal incision,the expectation and operation of extending face lifting are completed with a safe and convenient method,avoiding the risk of surgery.Using sub-SMAS plane relaxation,SMAS fl ap vertical vector lifting and imbricate outer upper vector lifting,we can truly realize the effective lifting of vertical vector to strengthen tissue sagging,and the natural tightening eff ect of outer upper vector to strengthen facial relaxation,so as to achieve the purpose of all-round facial lifting.