硅胶假体隆眉弓术  

Superciliary arch augmentation with silicone implant

作　　者：刘剑锋 王偲[2] 乔嘉 付茜 俞冰 陈莹 靳琦 徐史兴 牛峰 Liu Jianfeng;Wang Cai;Qiao Jia;Fu Xi;Yu Bing;Chen Ying;Jin Qi;Xu Shixing;Niu Feng(Department of Craniomaxillofacial Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Science,Peking Union Medical College,Beijing 100144,China;Department of Plastic Surgery,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]中国医学科学院北京协和医学院整形外科医院颅颌面一中心,100144 [2]北京大学人民医院整形外科,100044

出　　处：《中华整形外科杂志》2021年第5期547-553,共7页Chinese Journal of Plastic Surgery

基　　金：北京协和医学院教学改革项目(10023201800401)。

摘　　要：目的探讨硅胶假体隆眉弓术在治疗面上部轮廓低平中的应用效果。方法分析2018年7月至2020年9月,于中国医学科学院整形外科医院颅颌面一中心行硅胶假体隆眉弓术的女性求美者资料,纳入标准:眉骨低平、眼球突出或上睑臃肿。排除标准:额部曾行注射类手术或有注射物残留,眉骨区手术史,肿瘤史,甲状腺功能抗进或外伤史。根据眶上缘及眉弓区域解剖特点,在双侧眉尾下缘设计小切口,长度约7 mm,眉弓区域骨膜下剥离出与所雕刻假体大小合适的腔隙,并置入雕刻好的硅胶假体。雕刻假体时注意假体有效部分为下缘,厚度2~7 mm;假体中部为最上端,对应眉毛的内1/3处。假体两侧各设有1个小孔,允许术后组织长入。眉尾处假体与骨膜缝合固定,眉头处油沙钉打包缝合外固定。在术前、术后即刻和术后随访时拍摄照片并进行分析。术后满意度根据李克特5分量表由求美者、手术医师及非医学专业人员分别评分,数据以M(P25,P75)表示。应用SPSS 21.0软件采用多样本Kruskal-Wallis秩和检验进行统计分析,P<0.05为差异具有统计学意义。结果本研究共纳入42例求美者,年龄(25.1±3.1)岁(20~32岁)。手术均顺利完成,共置入硅胶假体84个,置入假体厚度(下缘)为(4.53±0.77)mm(2~7 mm)。所有求美者表情正常,均无包膜挛缩、伤口裂开及神经损伤。1例发生极少量血肿,术后1~2周自行吸收;1例在术后6个月发生无菌性炎症,最终行假体取出。随访(9.0±3.2)个月,范围6~18个月,除4例对外观轮廓不满意,接受再次手术外,其余求美者均得到了较满意的术后效果,与术前相比有明显改善,获得了更立体的眉弓和面上部三维轮廓,随访时面部容貌立体和谐。术后满意度评分:求美者为4.60(4.38,4.85)分(2.5~5.0分),手术医生为4.85(4.70,4.90)分(4.2~5.0分),非医学专业人员为4.80(4.66,4.90)分(3.7~5.0分)。3组满意度比较差异具有统计学意义Objective To investigate the efficacy and safety of superciliary arch augmentation with silicone implant in the treatment of upper facial flatness.Methods From July 2018 to September 2019,42 cases aged from 20-32(25.1±3.1)years old underwent superciliary arch augmentation with silicone implant.According to the anatomical characteristics of supraorbital margin and superciliary arch,A 7 mm surgical incision at the lower edge of the bilateral eyebrow tail was designed.The space was dissected close to the surface of superciliary arch bone and the carved silicone implant in accordance with the shape of the space was implanted.The effective part of the silicone implant was the lower edge,with a thickness of 2-7 mm.The middle part of of the silicone implant was the uppermost,corresponding to the inner third of the eyebrow.Each side of the implant had a small hole to allow tissues to grow in.The silicone implant at the eyebrow tail was sutured and fixed to the periosteum,and the vaseline gauze was packaged and sutured for external fixation at the eyebrow head.Photographs were taken and analyzed preoperatively,immediately after surgery,and at 6-18 months follow-up after surgery.Postoperative satisfaction was scored by patients,surgeons and laypersons according to the Likert 5 scale.SPSS Statistics 21.0 was used for statistical analysis using the Kruskal-Wallis rank sum test,and P<0.05 was considered to be statistically significant.Results 42 cases were followed up from 6 to 18(9.0±3.2)months.1case developed aseptic inflammation 6 months after surgery,and the implant was removed.Four cases were not satisfied with the facial contour and underwent revision surgery.1 patient developed hematoma,which was absorbed 2 weeks after surgery.The other cases were all satisfied with the results,which were significantly improved compared with the preoperative profiles.The superciliary arch and the upper facial contour were more three-dimensionally defined and the face was more harmonious during the follow-up.All cases had normal expre

关 键 词：弹性聚硅酮类 突眼 额骨 眉毛 整形外科 

分 类 号：R622[医药卫生—整形外科]