双平面交联透明质酸钠凝胶注射改善面颊部凹陷伴中下面部皮肤松弛的效果  

Clinical efficacy of restylane volyme cross-linked sodium hyaluronate gel injection via dual-plane technique for cheek depression and skin laxity in the mid-lower face

作　　者：王东 刘洋 来庆兰 陈光宇 Wang Dong;Liu Yang;Lai Qinglan;Chen Guangyu(Department of Cosmetic Surgery,Jinan MeiAo Plastic Surgery Hospital,Jinan 250000,China;Department of Dermatology,Hangzhou Xueran Medical Beauty Clinic,Hangzhou 311121,China;Cosmetic Injection Center,Plastic Surgery Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100144,China)

机构地区：[1]i梅奥整形外科医院(济南)美容外科,济南250000 [2]杭州雪然医疗美容诊所皮肤科,杭州311121 [3]中国医学科学院整形外科医院注射美容中心,北京100144

出　　处：《中华整形外科杂志》2024年第4期419-427,共9页Chinese Journal of Plastic Surgery

摘　　要：目的探讨采用双平面技术注射交联透明质酸钠凝胶改善面颊部凹陷伴中下面部轻中度皮肤松弛的效果和安全性。方法回顾性收集2023年2月至2024年1月梅奥整形外科医院(济南)收治的具有面颊部凹陷伴中下面部轻中度皮肤松弛的患者资料。治疗方案均采用双平面技术注射交联透明质酸钠凝胶,进针点位于耳屏前1~2 cm,进针后采用23 G钝针在面颊凹陷部的皮下脂肪浅层与皮下深层脂肪室2个平面进行扇形注射,并于颧弓下缘予适量的皮下注射以弱化突出的颧弓。单侧注射总剂量1.5~3.5 ml。注射过程中密切观察患者皮肤状态,注射后轻按压。术前、术后即刻、术后6个月分别采集患者图像,由盲测研究员采用面部松弛分级量表(FLRS)和中面部容积量表(MMVS)评价患者面部松弛及丰满度,量表评级或评分越高,代表面部越松弛或者丰满度越差,术后较术前评级或评分降低1级(分)即为有效,降低≥2级(分)为显著有效。由患者采用全球美学改善量表(GAIS)自评治疗前后的面部改善效果,满分5分,得分越高表明改善越明显。采用自制量表调查患者满意度及效果持久性。记录患者并发症情况。采用SPSS 26.0统计软件进行数据分析,计量资料数据用±s表示,同一患者术后即刻与术后6个月GAIS评分比较采用配对样本t检验;计数资料用例数(%)表示。结果共纳入80例女性患者,年龄30~50岁,均获得6个月以上随访。FLRS评价显示,与术前相比,术后即刻全部患者均评价为有效(69例,86.3%)或者显著有效(11例,13.8%);与术后即刻相比,术后6个月有74例(92.5%)患者评级无变化,6例(7.5%)患者评级升高1级,即治疗效果有所减弱。患者右、左侧MMVS评分显示,与术前相比,术后即刻全部患者均获得有效(右侧:55例,68.8%;左侧:69例,86.2%)或者显著有效(右侧:25例,31.2%;左侧:11例,13.8%)的改善效果;与术后即刻相比,术后6个月右、左侧分别ObjectiveTo explore the efficacy and safety of restylane volyme cross-linked sodium hyaluronate gel injection via dual-plane technique for cheek depression and mild to moderate skin laxity in the mid-lower face.MethodsThe data of patients with cheek concavity accompanied by mild to moderate skin laxity in the mid-lower face treated at Jinan MeiAo Plastic Surgery Hospital from February 2023 to January 2024 were retrospectively collected.The treatment was injection of cross-linked sodium hyaluronate gel via double-plane technique,with needle insertion points located 1-2 cm anterior to the tragus.After insertion,a 23 G blunt needle was used to fanwise inject the subcutaneous fat(superficial layer)and the subcutaneous(deep layer)fat compartments in the concave area of the cheek,and a suitable amount of subcutaneous injection was administered below the zygomatic arch to soften the prominent zygomatic arch and achieve natural smoothness of the filling area.The total volume injected per side ranged from 1.5 to 3.5 ml.The patient’s skin condition was closely observed during the injection process,followed by gentle compression after injection.Patient images were collected preoperatively,immediately postoperatively,and at 6 months postoperatively.Blind evaluator used the facial laxity rating scale(FLRS)and medicis midface volume scale(MMVS)to evaluate the improvement in facial laxity and fullness.A higher rating/score of the scale indicates greater laxity or worse fullness of the face,and a decrease of 1 grade/point postoperatively compared to preoperative status was considered effective,while a decrease of≥2 grades/points was considered significantly effective.Patients used the global aesthetic improvement scale(GAIS)to self-assess the improvement in facial appearance before and after treatment,with a maximum score of 5 points indicating the most noticeable improvement.Patient satisfaction and effect durability were investigated using a self-made satisfaction scale.The occurrence of patient complications was recorded.

关 键 词：透明质酸 交联型透明质酸 双平面注射技术 面颊凹陷 面部皮肤松弛 

分 类 号：R622[医药卫生—整形外科]