保留与重置眶隔脂肪在下睑成形术中的应用  

Application of Orbital Fat Preservation and Repositioning in Lower Blepharoplasty

作　　者：翟亚东 章宏伟[2] ZHAI Yadong;ZHANG Hongwei(Department of Cosmetic Surgery,Nanjing Huahanqizhi Plastic Surgery Hospital,Nanjing 210000,Jiangsu,China;Department of Plastic Surgery,Friendship Plastic Surgery Hospital of Nanjing Medical University,Nanjing 210000,Jiangsu,China)

机构地区：[1]南京华韩奇致美容医院整形外科,江苏南京210000 [2]南京医科大学友谊整形外科医院整形外科,江苏南京210000

出　　处：《中国美容医学》2022年第5期79-82,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨保留与重置眶隔脂肪在伴泪槽畸形和/或睑颊沟凹陷的下睑成形术的应用效果。方法:选取2020年3月-2021年2月在笔者医院行下睑成形术的57例就医者(114眼),Ⅰ级共8眼,Ⅱ级共75眼,Ⅲ级共31眼。手术方法为经皮肤入路,行弓状缘释放、眶隔脂肪保留并重置平铺及眼轮匝肌瓣悬吊缝合固定于眶外侧骨膜上,矫正睑袋及泪槽畸形和/或睑颊沟凹陷。结果:随访6~18个月,1例老年男性就医者右侧出现轻度下睑外翻,后行二次手术予以矫正。余下56例就医者均获得满意效果,31眼Ⅲ级泪槽畸形6眼转为Ⅰ级,所有Ⅰ级(8眼)、Ⅱ级(75眼)及其余Ⅲ级(25眼)泪槽畸形均消失,下睑皮肤松弛及睑袋膨隆明显改善,无下睑退缩、外翻等并发症。结论:采用保留与重置眶隔脂肪治疗睑袋伴泪槽畸形和/或睑颊沟凹陷,手术效果好,复发风险低,并发症发生率低。Objective To investigate the application eff ect of orbital fat preservation and repositioning in lower blepharoplasty with tear trough deformity and/or palpebro-malar groove depression.Methods 57 patients(114 eyes)who underwent lower blepharoplasty in our hospital from March 2020 to February 2021 were selected.8 eyes were Harmind ClassⅠ,75 eyes of Harmind ClassⅡand 31 eyes of Harmind ClassⅢ.The surgical methods were through skin resection,arcus marginalis release,orbital septum fat preservation,septal reset,improvement of tear trough deformity and palpebro-malar groove depression,suspension and suture of orbicularis oculi muscle flap and fixation in the thickened area of extraorbital ligament,so as to correct the lower eyelid bags.Results Followed up for 6~18 months,1 elderly male patient had mild lower eyelid ectropion on the right side,which was corrected by secondary operation.The remaining 56 patients achieved satisfactory results.6 eyes of Harmind classⅢreverted to class I.all class I(8 eyes),classⅡ(75 eyes)and the remaining classⅢ(25 eyes)tear trough deformities disappeared,the lower eyelid skin relaxation and eyelid pouch were significantly improved,and there were no complications such as lower eyelid retraction and ectropion.Conclusion The method of orbital fat preservation and repositioning in the treatment of lower blepharoplasty with tear trough deformity and/or palpebro-malar groove depression has good surgical eff ect,reduces the risk of recurrence and low incidence of complications.

关 键 词：睑袋 泪槽畸形 睑颊沟凹陷 下睑成形术 眶隔重置 

分 类 号：R622[医药卫生—整形外科]