“三重提紧技术”在中下面部提升中的应用  

Use the technique of three layers suspension to lift the mid-low face

作　　者：夏东胜[1] 何冬梅[1] 周蓉蓉[1] 郑丽君[1] 赵启明[1] 

机构地区：[1]解放军第一一七医院整形美容中心,杭州310013

出　　处：《中华医学美学美容杂志》2017年第3期152-155,共4页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的 探索“三重提紧技术”在中下面部提升中的应用价值.方法 对22例中下面部松垂的美容就医者,采用颞部发际线-耳前-耳后乳突区皮肤切口.术中进行大范围的面部皮下分离（颧部则在颧脂垫与骨膜间分离,但保留其与皮肤粘连）,然后采用浅表肌腱膜系统（SMAS）定向荷包收紧、颧脂肪垫提升复位、皮肤递进减小张力-重建面部支持韧带粘着点的“三重提紧技术”行中下面部提升（除皱）术.剪除颞部发际缘-耳前-耳后乳突区多余皮肤后,切口在无张力情况下缝合.术区加压包扎,术后第7天拆线.以美容就医者满意程度评价手术效果,分为很满意、满意、不满意3个等级.结果 22例均未发生感染、皮肤坏死、面神经损伤等并发症.其中16例术后3～24个月获得随访,鼻唇沟显著变浅、颌颈角显现、面部术区皮肤紧致、表情自然对称,自我评价非常满意者14例（87.5％）,满意者2例（12.5％）,满意度100％.结论 利用“三重提紧技术”进行中下面部提升（除皱）,对于改善面部表情区,特别是改善鼻唇沟附近、下颌缘区的软组织松垂老化现象,具有明显效果.该方法简便、有效、易推广.Objective To explore an ideal surgical method for mid-low face lifting.Methods In this procedure,the first surgical step was subcutaneous undermining that was performed through the incision along temporal hairline,anteriorear,and mastoideae.It extended distally beyond the furthest skin fold and along the mandibular border or the midline of the neck if nacessary.Then three layers suspension were performed,which included three procedures：first,SMAS was purse string sutured in certain direction;secondly,the malar fat pad was suspended to tow directions backward and upward and anchored in the periosteum of zygoma and SMAS too;lastly,through traction suture of reducing tension step-by-step,lots of the tension was relieved from the incision;at the same time,new retaining ligaments between flap and SMAS were reestablished.And redundant skin was removed in incision at the end of the procedure.Results A total of 22 cases received this operation.16 cases were followed up from 3 months to 24 months after operation.The results of operation were divided into three degrees：excellent,acceptable and poor;and those were evaluated by patients themselves.14 cases obtained excellent result （87.5 %）,2 cases regarded that their results were acceptable （12.5 %）.The total satisfactory rate was 100 %.None serious complication occurred in those eases except some slight complications,such as local edema,skin numbness and small hematoma which relieved in 3 to 6 months after operation.Scar was inconspicuous.Conclusions This technique can correct the posies of lower tow-third face better,especially for mitigating the nasolabial fold and enhancing the elastic of face skin.Simultaneously,it is an effective,safe and simple technique.

关 键 词：除皱术 浅表肌腱膜系统 颧脂肪垫 

分 类 号：R62[医药卫生—整形外科]