下睑成形联合眶隔脂肪重置纠正睑袋和泪沟畸形的手术方法进展  

Surgical techniques of lower blepharoplasty with fat repositioning in correcting eyelid bags and tear trough deformities

作　　者：鞠礼佳 王太玲 JU Lijia;WANG Tailing(Department of Facial and Nech Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Sciences&Pehing Union Medical College,Beijing 100144,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面颈整形科,北京100144

出　　处：《中国美容整形外科杂志》2025年第1期25-29,共5页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：首都卫生发展科研专项项目(首发2024-2-4042)。

摘　　要：睑袋和泪沟畸形是眼部整形手术中常见的美学问题,常随年龄的增长逐渐出现,造成面部疲倦、老态的外观。睑袋和泪沟形成对应的治疗方式也在更新迭代,包括下睑手术和微创注射填充等。其中,手术治疗是最直接、彻底矫正睑袋和泪沟的方法,在R Loeb于1981年最早提出眶隔脂肪转位矫正术后,整形外科医师们的手术观念从单纯切除脂肪转为对眶隔脂肪的再利用,用于填充下睑和面中部的凹陷。下睑成形联合眶隔脂肪重置术包括入路选择、韧带处理、眶隔脂肪重置和固定等复杂步骤,每一步骤又有着不同的选择及其适应证。现通过回顾总结睑袋及泪沟形成的解剖学研究、下睑成形联合眶隔脂肪重置的各种手术方法、手术评价方式和手术并发症,以了解该术式的发展和临床应用现状,帮助整形外科医师更好的选择最适宜患者的个体化手术方式,取得良好手术效果。Tear trough deformities and eyelid bags are common aesthetic issues.They frequently develop gradually as people age,giving their faces a worn-out,senile appearance.The development of eyelid bags and tear troughs has been the subject of continuous anatomical research,and the associated therapeutic approaches such as lower eyelid surgery and minimally invasive injectable filling are also being updated and improved.The most straightforward and comprehensive approach to treating eyelid bags and tear troughs is surgery.Plastic surgeons'surgical philosophy shifted from fat removal to the reuse of orbital fat to fill up the midface and lower eyelid depressions following Loeb's initial proposal of the orbital fat transposition treatment in 1981.Complex procedures,including approach selection,ligament therapy,orbital fat repositioning,and fixation are all part of lower blepharoplasty with orbital fat repositioning.Each stage has its options and indications.This article reviews and summarises the anatomical research,various surgical techniques,surgical evaluation methods and surgical complications to help plastic surgeons better understand the procedure's development and clinical application status.It also helps them select the best individualised surgical technique for each patient and achieve positive surgical outcomes.

关 键 词：下睑成形术 眶隔脂肪重置 睑袋 泪沟畸形 手术评价 

分 类 号：R47[医药卫生—护理学]