A型肉毒毒素微滴注射改善下睑皮肤细纹的临床观察

Microbotox injection for alleviating fine wrinkles at the lower eyelid

目的研究A型肉毒毒素微滴注射方法改善下睑皮肤细纹,实现眼周年轻化的临床效果。方法回顾性分析2022年8月至2023年1月中国医学科学院整形外科医院面颈整形中心、广元市中心医院医疗美容科、青神县人民医院皮肤科、都江堰市人民医院整形美容外科、攀枝花市妇幼保健院女性健康管理中心和成都八大处医疗美容医院收治的下睑皮肤轻度松弛伴细纹患者的临床资料。采用微滴注射方法进行治疗,将稀释浓度为8 U/ml的A型肉毒毒素以0.6 cm为间隔,广泛、微量地注射于下睑眼轮匝肌解剖区域的真皮层或真皮与肌肉浅层之间,单点注射0.2 U。术后对患者进行随访,调查患者满意度,分为十分满意、满意、不满意、十分不满意,计算主观满意度(十分满意与满意例数占总例数的百分比);同时,由第三方医师采用全球美学改善评分量表(GAIS),对治疗前和随访时的患者照片进行评分,5分为较前更差,4分为无改善,3分为轻微改善,2分为中等改善,1分为显著改善。采用SPSS 24.0软件对数据进行描述性分析。结果共纳入23例患者,其中男1例,女22例,年龄(36.4±2.5)岁。随访1~6个月,平均1.4个月,患者主观满意度为100%(23/23)。GAIS评分为(1.26±0.54)分,100%(23/23)的患者达到显著改善或中度改善标准。并发症方面,2例患者出现注射后局部淤血,最迟在1周后恢复;1例主诉注射后疼痛,12 h后明显缓解;无眼睑外翻、睑球分离、闭合不全、面瘫、眼干涩或其他并发症。结论应用A型肉毒毒素微滴注射可改善眶周皱纹,同时提升皮肤质地,获得了良好效果。

Objective To evaluate the clinical effect of microbotox injection of botulinum toxin type A in improving the fine lines of lower eyelid skin and achieving the rejuvenation of the eye area.Methods The clinical data of patients with mildly sagging lower eyelid skin and fine wrinkles admitted to Facial and Neck Plastic Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College;Deparment of Plastic and Cosmetic Surgery,Guangyuan Central Hospital;Department of Dermatology,People’s Hospital of Qingshen County;Department of Plastic and Cosmetic Surgery,Dujiangyan People’s Hospital;Devision of Women’s Healthcare,Panzhihua Maternal and Child Hospital;Chengdu Badachu Cosmetic Hospital from August 2022 to January 2023 were analyzed retrospectively.Using the microbotox injection method,the botulinum toxin type A with a diluted concentration of 8 U/ml was micro-injected into the dermis layer or between the dermis and the superficial muscle layer at an interval of 0.6 cm,and a single point injection of 0.2 U.The injection range was the anatomical distribution range of the orbicularis oculi muscle.After treatment,patients were followed up to investigate patient satisfaction,which was divided into very satisfied,satisfied,dissatisfied and very dissatisfied,and to calculate subjective satisfaction(percentage of the number of very satisfied and satisfied cases in the total number of cases).At the same time,a independent physician used the global aesthetic improvement scale(GAIS)to evaluate the effect based on the patient’s photos before treatment and during follow-up.5 indicates as worse than before,4 as no improvement,3 as were slight improvement,2 as moderate improvement,and 1 as significant improvement.SPSS 24.0 software was used for descriptive analysis of the data.Results A total of 23 patients were enrolled,including 1 male and 22 females,aged(36.4±2.5)years old.The follow-up was 1-6 months,with an average of 1.4 months,and the subjective satisfaction of patients was 100%(23/23).The result of the independent physician evaluation were as follows:the overall cosmetic improvement score of the observers was 1.26±0.54,100%(23/23)of the patients reached the standard of obvious or moderate improvement.In terms of complications,2 patients presented local epidermis bruises after injection,who recovered within 1 week;1 patient complained of pain after injection,which was significantly relieved 12 hours later.No ectropion,symblepharon,facial palsy,dry eyes,or other complications were observed.Conclusion Application of botulinum toxin type A microbotox injection can improve periorbital wrinkles and improve skin texture at the same time,and the therapeutic effect is definite.