上睑提肌缩短术矫正重睑成形术后皱褶过宽畸形的临床效果  

Value of levator shortening for correction of high supratarsal fold after cosmetic upper blepharoplasty

作　　者：张君毅[1] 郑永生[1] 王春梅 闫伦 

机构地区：[1]首都医科大学附属北京同仁医院整形美容中心,100730 [2]广东东莞康华医院整形美容中心

出　　处：《中华医学美学美容杂志》2016年第6期355-357,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨应用上睑提肌缩短术矫正重睑成形术后皱褶过宽畸形的临床效果。方法针对34例重睑成形术后皱褶过宽畸形且双侧上睑皮肤及眶隔脂肪量不足者，设计新重睑线，切除原重睑线与新重睑线之间的皮肤（包括原瘢痕），松解组织粘连，酌情缩短表面瘢痕化的上睑提肌腱膜，按设计弧度依次间断缝合皮肤与上睑提肌腱膜组织，形成新重睑。结果34例重睑形态均得到改善。32例（94．1％）矫正效果满意。1例（2．9％）因矫正术后两侧重睑宽度不对称而行二次修复术，二次修复术后重睑形态满意，1例（2．9％）因矫正术后重睑皱褶过深，效果不满意。结论重睑成形术后皱褶过宽畸形，特别是对于眶隔脂肪缺失及上睑皮肤量不足者，通过缩短表面瘢痕化的上睑提肌腱膜，使上睑皮肤、肌肉及脂肪组织量相对富裕，不仅可有效降低重睑高度，预防因上睑提肌暴露而造成的再次粘连，还可矫正上睑下垂。Objective To correct the high supratarsal fold after cosmetic upper blepharoplasty is a challenge because of the shortage of both upper eyelid skin and fat. Levator shortening has been a procedure of choice selected by the surgeons to correct this condition. Methods Under local anesthesia, the desired crease was marked according to the characteristics of eyelid anatomy and aesthetic consideration for Asian women. The incision was made through the marked new skin crease and the old incision with surrounding scar tissue was incised. The adhesion between the skin and the levator aponeurosis was completely released. The levator aponeurosis was then divided above the tarsal plate. It could be shortened and then reattached to the tarsal plate depending on the amount of the upper eyelid skin and the degree of the ptosis. The skin incision was then closed to form new but lowered fold. Results Between 2003 to 2015, a total of 34 Chinese women underwent bilateral levator shortening for correction of high supratarsal fold after previous unsatisfactory upper blepharoplasty by other surgeons. There were no surgical complications postoperatively in this series and 32 patients （94.1%） were satisfactory for the outcome of the proper height of the supratarsal fold with at least 1 month follow-up. Only one patient （2.9 %） required surgical revision for asymmetry of supratarsal folds and one patient （2.9%） for correction of deepened supratarsal fold. Conclusions The levator shortening can be an effective procedure to correct high supratarsal fold after unsatisfactory upper blepharoplasty in Asian women. It is especially useful to correct such a condition where there is shortage of the eyelid skin combined with the eyelid ptosis.

关 键 词：上睑成形术 上睑提肌缩短术 皱褶过宽畸形 

分 类 号：R779.6[医药卫生—眼科] R622[医药卫生—临床医学]