皮肤美容及整容

20090327绿茶在皮肤美容中的应用研究进展（综述）;20090328针灸在皮肤科美容相关疾病中的应用（综述）;20090329射频技术治疗面颈部皮肤皱纹和松弛的临床疗效观察;20090330内路法手术联合超脉激光除皱整复下眼袋     

不同术式眼袋整复术的临床应用

目的探讨不同眼袋整复术的临床适应症及操作要点。方法 178例患者根据临床表现分为单纯眶隔脂肪增多型、眶隔脂肪增多伴下睑皮肤松弛型及下睑皮肤松驰伴眶下缘凹陷型3型,分别采用结膜入路法、皮肤入路法及眶下脂肪释放填充术进行眼袋整复术。结果 178例手术患者,120例随访12个月,114例患者术后下睑眼袋消失,患者自觉满意。其中4例因去除脂肪较少,3月后行结膜入路去除多余脂肪后效果满意;2例患者术后下睑缘不平凹陷,3月后行眶下脂肪释放填充术,术后效果满意;2例患者因术中出血,术后出现下睑皮肤淤青肿胀、下睑缘睑球轻度分离及球结膜下轻度出血,但术后1个月恢复正常效果并自觉满意。结论根据临床分型采取不同的眼袋整复手术方式,治疗效果良好。     

改良的下睑缘切口在眼袋整复术及中面部年轻化中的应用

目的:探讨改良的下睑缘切口在眼袋整复术及中面部除皱术中的应用。方法:经下睑缘切口完成眼袋整复术,并行眼轮匝肌、中面部SMAS筋膜的悬吊以达到面部年轻化的效果。结果:50例患者术后经过3～18个月术后随访,眼袋去除,面中部松弛得以改善,鼻唇沟纹变浅,部分鱼尾纹消除,面部年轻化效果明显。结论:下睑缘切口设计隐蔽而合理,术中创伤小,手术效果好,适用于眼袋明显及面中部轻、中度松弛患者。     

重睑成形术结合眉埋线法治疗上睑皮肤松弛

中青年人上睑皮肤松弛一般表现为上睑皮肤皱纹增多、褶皱加深、上睑皮肤松弛、睁眼疲劳，甚至倒睫等。治疗上可采用单纯手术切除多余上睑皮肤，使睑缘与眉毛之间距离靠近．行眉上皮肤切除法眉提升术，因在眉上可能留下瘢痕往往不为患者所接受。为此，笔者采用埋线法固定眉于眉骨，再结合重睑成形术修复上睑松弛，共治疗23例患者，术后效果良好，现报告如下。[第一段]     

超脉冲CO_2点阵激光联合肉毒素治疗面部皮肤老化临床研究

目的观察超脉冲CO_2点阵激光联合肉毒素治疗面部皮肤老化的临床效果。方法选取2018年7月至2020年3月某医学美容科收治的50例皮肤老化患者作为研究对象,随机分为对照组(注射除皱治疗,n=25)、研究组(超脉冲CO_2点阵激光辅助注射除皱治疗,n=25),总疗程3个月。比较两组间面部皮肤皱纹、纹理、水分、弹性评分,临床治疗有效率。结果足疗程后,研究组皮肤皱纹、纹理评分低于对照组,而皮肤水分、弹性评分高于对照组(P 0.05)。研究组患者治疗总有效率高于对照组(P 0.05)。结论对于面部皮肤老化患者,予以超脉冲CO_2点阵激光联合注射除皱治疗可改善患者面部老化评分,提高疗效。     

2940nm铒激光SMOOTH模式联合长脉冲1064nm Nd:YAG激光治疗面部皮肤光老化50例疗效观察

目的探讨2940nm Er:YAG激光SMOOTH模式联合长脉冲1064nm Nd:YAG激光治疗面部皮肤光老化临床疗效和应用价值。方法将96例皮肤光老化患者随机分成两组,治疗组(50例)采用2940nm铒激光SMOOTH模式联合长脉冲1064nm Nd:YAG激光治疗,对照组(46例)采用长脉冲1064nm Nd:YAG激光治疗。比较两组患者治疗前后面部皱纹、皮肤松弛、毛孔及皮肤光泽度的改善情况,评估临床疗效。结果医生评估:治疗组和对照组患者皱纹改善率分别为88.00%,63.04%;皮肤松弛程度改善有效率分别为92.00%,65.21%;毛孔改善有效率分别为86.00%,65.21%;皮肤光泽度改善有效率为90.00%,82.61%。患者自评:治疗组和对照组患者皱纹改善率分别为84.00%,60.87%;皮肤松弛程度改善有效率分别为88.00%,63.04%;毛孔改善有效率分别为80.00%,58.70%;皮肤光泽度改善有效率为86.00%,78.26%。治疗组和对照组患者5次治疗后面部皱纹、皮肤松弛、毛孔的改善有效率差异有统计学意义(P0.05)。结论 2940nm铒激光SMOOTH模式与长脉冲1064nm Nd:YAG激光联合应用对面部皮肤光老化的治疗效果优于单纯使用长脉冲1064nm Nd:YAG激光治疗。     

眉下切口皮肤切除矫正上眼睑皮肤松弛和鱼尾纹32例

目的介绍经眉下切口皮肤切除治疗上眼睑皮肤松弛下垂和眼角鱼尾纹的经验和体会。方法对32例上睑皮肤松驰但无明显眉下垂的患者,在眉下缘和上眼睑之间去除多余的皮肤,皮肤缝合后切口隐蔽在眉下。结果本组所有患者通过该术式,矫正了上眼睑松弛下垂的皮肤,眼裂增大,视野增大,术后眉位置无明显变化,眼角皱纹减少。随访半年,效果满意。结论经眉下切口皮肤切除治疗上眼睑皮肤松弛下垂和眼角鱼尾纹,术后可获得满意的美容效果。     

肌皮瓣联合外1/3皮瓣法下睑袋成形术

目的 在肌皮瓣法手术操作基础上,于下睑外1/3区域联合应用皮瓣法,进一步提高睑袋整复效果。手术方法 对37例行下睑袋成形术者,采用下睑缘切口,并将切口外侧延长线藏于外眦皱褶线内,先行肌皮瓣法操作,同时行外眦固定术,于下睑外侧1/3运用皮瓣法。结果 术后恢复快,下睑皮肤平展,外眦部皮肤去除充分,张力适度。术后6个月至1年观察,无睑退缩、下睑外翻,外侧切口瘢痕隐蔽,随访效果满意。结论 运用肌皮瓣法联合外1/3皮瓣法下睑袋成形术效果良好,外眦角自然,术后效果满意,达到下睑年轻化矫治的目的。     

小切口除皱术

目的通过耳屏前小切口,悬吊SMAS,以改善面颊部及下颌部,口角部的皮肤松弛下垂、达到面部除皱效果。方法对50例轻度面颊部及下颌部、口角部松弛下垂及皱纹的患者沿耳屏切迹及耳垂部的皮纹线S型切开,分离、悬吊SMAS、切除耳前多余皮肤。结果50例均达到了面颊部及下颌部、口角部除皱的良好效果。结论耳屏小切口加SMAS悬吊术,不仅手术操作简单、安全、损伤小、恢复快,能达到切口瘢痕最小化,而且能改善面部整体形态,达到年轻化的效果。     

A型肉毒毒素消除面部皱纹100例临床观察

目的：观察A型肉毒毒素(BTXA)去除面部皱纹的疗效，探讨BTXA皮肤除皱的方法及降低药物副作用的发生。方法：对100例患者应用BTXA局部多点注射。结果：面部皮肤除皱有效率100％，皮纹变浅、变平而且光滑，效果通常持续3～6个月。局部副作用轻微、短暂且可自行消失，无全身不良反应。结论：注射BTXA是暂时性消除面部皱纹的安全、有效、简便的治疗方法，但应注意操作规程及适当剂量。     

Bilateral Congenital Entropion with Cutis Laxa

Cutis laxa is a rare connective tissue disorder characterized by redundant and pendulous skin due to a defect in the elastic fiber network. Two cases of entropion associated with cutis laxa have been reported, although entropion was due to elongation of the anterior lamella or horizontal lid laxity. Thorough systemic and ophthalmic evaluations were performed, as well as chart review for the perinatal period. Surgical correction of entropion through posterior tarsotomy was done. An infant boy with dysmorphic features and furrowing of the skin of the entire body without hyperelasticity, which is typical for cutis laxa, presented with bilateral congenital entropion. We report here for the first time a different etiology of congenital entropion with cutis laxa: the eyelashes were abnormally directed due to the unusual location of their roots, which were embedded within the tarsus. Moreover, this is the only case of cutis laxa with congenital entropion involving both upper and lower eyelids. Congenital entropion can be associated with cutis laxa. Although elongation of the anterior lamella and horizontal lid laxity predispose to such an entropion, abnormal location of the roots of the eyelashes might be encountered and marginal eyelid rotation surgery is indicated.     

Acquired localized cutis laxa confined to the face: case report and review of the literature

BACKGROUND: Cutis laxa is an uncommon entity characterized by laxity of the skin, which hangs in loose folds, producing the appearance of premature aging. It can be subdivided into congenital and acquired. This latter variant is rare and the skin involvement varies from generalized to localized. We report a case of a localized acquired cutis laxa confined to the face, without preceding inflammatory lesions or systemic compromise. Four similar cases have been reported to date. The etiology remains unknown and there is no definitive treatment. METHODS: A 27-year-old White woman came to our hospital with a wrinkled face, pendulous earlobes and drop eyelids. Changes began 5 years prior, and she appeared much older than her age. RESULTS: Histological analysis and ultrastructural examination of skin biopsy revealed reduction and fragmentation of elastic fibers, confirming the diagnosis of cutis laxa. No systemic involvement was diagnosed. The patient was submitted to plastic surgery for repair, with satisfactory results to date. CONCLUSIONS: Acquired localized cutis laxa confined to the face without preceding inflammatory lesions is extremely rare. The etiology remains unknown. Clinical features and histopathologic findings confirm the diagnosis. Surgical repair seems to be the only therapeutic choice, but the results are variable and temporary.     

Blepharoplasty: indications, outcomes, and patient counseling

A tell-tale sign of the aging face is upper eyelid skin redundancy and lower eyelid bags. These changes can contribute to a "tired" appearance. Upper and lower blepharoplasty procedures can correct these processes. By removing skin and muscle, an upper eyelid blepharoplasty can give the eye a larger appearance. A lower blepharoplasty can remove pseudo-herniated fat, or transpose it to provide a smooth infraorbital contour. It appears that a transconjunctival approach for the lower blepharoplasty will lead to a lower incidence of eyelid malposition. An adjunctive procedure such as laser resurfacing may be appropriate. Patients should be counseled on all potential complications, including visual loss from muscle injury or hematoma, as well as the extent of postoperative recuperation.     

Stellenwert der Oberlidkorrektur in der Dermatochirurgie

Upper eye lid blepharoplasty is one of the most commonly practiced surgical treatments in aesthetic medicine. Careful patient selection, thorough preoperative planing, and exact surgical treatment lead to optimal results. CO₂ laser assisted surgery provides a dry and clear surgical field, allowing precise tissue control. On the other hand CO₂ laser subsurfacing leads due to thermal effect to a shrinking of the lax orbital septum, and reduces the need for orbital fat resection or even allows one to avoid fat resection. Periorbital combination treatments in most cases allow smaller or less invasive procedures, reducing risk factors. Additionally they adapt to individual anatomic structures, different needs in outcome and show synergistic effects. Aesthetic dermatology incorporates many conservative and invasive approaches, so that upper eyelid blepharoplasty in dermatologic surgery is widely accepted and well-established.     

Ultra-minimal pinhole blepharoplasty: A minimally invasive technique for the correction of eyelid bags

Objective

The aim of the study was to investigate the efficacy and complications of ultra-minimal pinhole blepharoplasty in the treatment of eyelid bags.

Methods

This retrospective study included patients with eyelid bags treated using a minimally invasive blepharoplasty technique between May 2018 and June 2021. The postoperative course and complications and patient satisfaction were analyzed.

Results

A total of 460 patients (136 males and 324 females) were included with a mean age of 42.12 ± 9.76 years. The mean operative time was 24.3 min. After the operation, the patients had no infection, numbness, or lower eyelid varus, valgus, or withdrawal. Nine patients developed transient binocular diplopia, which disappeared 0.5–1 h after surgery. Two patients developed chemosis, which disappeared after therapy. Six months after the operation, 440 (95.65%) patients were satisfied with improvement in their fat bulge. A total of 434 (94.78%) patients were satisfied with improvement in their tear groove.

Conclusion

Ultra-minimal pinhole blepharoplasty is a safe, effective, and minimally invasive treatment for eyelid bags.     

结合颧脂肪垫及颧大肌悬吊复位的内窥镜面中上部年轻化手术

目的采用创伤较小的方法来矫正面中上部老化,尤其是鼻唇沟过深及口角下移。方法面中上部采用内窥镜上提之后,采用下睑缘切口,颧大肌起点上移,固定于眶外侧骨膜或颞肌表面,牵拉上移颧脂肪垫,使之复位,提升口角,矫正过深鼻唇沟。结果26例术后,无头皮麻木,脱发,无明显瘢痕,无下睑外翻、面神经损伤、血肿并发症,观察期为6个月～3年,无下垂复发,效果均十分满意。结论术式创伤小,切口小而隐蔽,矫正鼻唇沟过深效果肯定。     

颌面部骨折切口设计的美容观点及其临床应用

目的以美容观点探讨外伤性颌面部骨折手术入路的切口设计。方法对14例面中部骨折及29例下颌骨骨折的患者采用经皮冠状切口或附加下睑缘切口、口内前庭沟切口、耳屏后缘切口,行骨折复位及小(微)型钛板内固定术。结果14例面中部骨折中,13例骨折及面部外形全部恢复良好。1例出现轻度睑内翻,术后一周消失。29例下颌骨骨折患者,术后面部外观对称。所有病例术后伤口一期愈合,切口隐蔽、细微,无1例感染。结论冠状切口及附加下睑缘切口、口内前庭切口治疗颌面部骨折,切口隐蔽、美观,术区暴露清楚、直视下内固定方便,术后患者反映好,在临床上广泛应用。     

Acquired cutis laxa secondary to Sweet syndrome in a child (Marshall syndrome): A rare case report

Sweet syndrome is rare in the pediatric population and usually responds well to treatment, resolving without sequelae. Marshall syndrome is a rare pediatric skin disease characterized by loss of elastic tissue (cutis laxa) secondary to acquired, localized neutrophilic dermatitis without any internal organ involvement. Only few cases of Marshall syndrome (acquired cutis laxa type II) have been reported. Systemic steroids and dapsone show excellent results in Sweet syndrome. Although there is no satisfactory treatment for cutis laxa, dapsone can be used in the acute phase for control of swelling.