高位SMAS联合骨膜下眉尾提升术在面部年轻化中临床应用  

Clinical application of high position SMAS combined with subperiosteal eyebrow tail lifting surgery in facial rejuvenation

作　　者：王进刚 刘敬春 王希华 张宁 扈丽娟 谢立宁 WANG Jing-gang;LIU Jing-chun;WANG Xi-hua;ZHANG Ning;HU Li-juan;XIE Li-ning(Jining Star Oxygen Plastic Surgery Hospital,Shandong Province,272000,China;Longgang Huamei Xihua Medical Beauty Clinic,Liaoning Province,125000,China;Friendship Plastic Surgery Hospital of Nanjing Medical University,Jiangsu Province,210000,China)

机构地区：[1]济宁星氧整形美容医院,山东济宁272000 [2]龙港华美希华医疗美容门诊部,辽宁葫芦岛125000 [3]南京医科大学友谊整形外科医院,江苏南京210000

出　　处：《中国医疗美容》2023年第11期7-12,共6页China Medical Cosmetology

摘　　要：目的探讨高位SMAS面颈部提升术联合骨膜下眉尾提升的手术方法的临床效果。方法2019年9月至2022年9月,220例患者在本院接受高位SMAS面颈部提升术,其中50例联合骨膜下眉尾提升术,SMAS分离的范围,向上平外眦,向下到达下颌缘下2 cm,颧骨体内侧越过颧大肌,向前内侧分离至颧前间隙、上颌前间隙、咬肌前间隙,软组织得到有效提升为止;颞嵴内侧拟提升眉尾平面额部骨膜下剥离,眶周和额-颞移行区充分分离,上提颞顶筋膜并无张力固定到颞深筋膜上至眉尾有效提升为止。结果本组220例患者术后随访六个月到二年,均取得面部年轻化的效果,未发生面神经永久损伤,以及皮瓣坏死等严重并发症。结论高位SMAS瓣联合眉尾骨膜下提升,让衰老的求美者恢复年轻态,但此手术对术者要求较高,术者对面部层次、间隙、和韧带在内的解剖结构非常熟悉。另外本研究随访期有限,因此需要更多的随访时间来确定合适的整容方法。Objective To investigate the clinical effect of high SMAS facial and neck lift combined with subperiosteal eyebrow tail lift.Methods From September 2019 to September 2022,220 patients underwent high SMAS face and neck lift in our hospital,including 50 cases combined with subperiosteal eyebrow tail lift,the range of SMAS separation,upward to external canthus,down to 2 cm below the mandibular margin,the inner side crossed the zygomaticus major muscle,and the anteromedial side was separated to the prezymatic space,the anterior maxillary space,and the anterior masseter space,until the soft tissues were effectively lifted.The medial side of the temporal crest is intended to lift the eyebrow tail plane,the frontal subperiosteal is dissected,the periorbital and frontaltemporal transition areas are fully separated,and the superficial temporal fascia of the levator temporal is fixed to the deep temporal fascia without tension until the eyebrow and tail are effectively raised.Results All 220 patients in this group were followed up for six months to two year after surgery,and all of them achieved facial rejuvenation effect,without permanent damage to facial nerve,and serious complications such as flap necrosis.Conclusion High SMAS combined with subperiosteal lifting of the eyebrow tail can restore the youthful appearance of aging beauty seekers,but this surgery has higher requirements for the operator,the surgeon is very familiar with the anatomy including facial layers,spaces,and ligaments,and the follow-up period of this study is limited,so more follow-up time is needed to determine the appropriate cosmetic method.

关 键 词：面部年轻化 SMAS 眉尾提升术 骨膜 

分 类 号：R622[医药卫生—整形外科]