眶隔脂肪选择性释放结合前壁组织加强的下睑袋整复术

目的：探讨采用眶隔脂肪选择性释放、转移，切除部分皮肤，结合眶隔前壁组织加强矫治松弛膨隆型下睑袋的美学效果。方法：对36例中老年下眼睑松弛并睑袋膨隆突出的就医者，采用传统皮肤入路，眶下缘松解眶隔，分组释放出眶隔脂肪，根据就医者各自情况，选择性摘除部分脂肪，其余脂肪组织充填修复眶下缘凹陷畸形，再紧缩眶隔、眶肌筋膜固定，眼轮匝肌悬吊以加强眶隔前壁，适当去除多余皮肤，关闭切口。结果：本组36例就医者，其中30位获随访3～20个月，除1例切1：3痕迹较为明显外，其他就医者下睑区皮肤平坦紧致，无睑外翻、下睑退缩、外眦下垂等并发症，对下睑皱纹的去除及中面部提升效果明显，医患满意。结论：眶隔脂肪选择性释放结合眶隔前壁组织加强是矫治老年性下睑袋膨突合并眶缘“沟槽样”凹陷畸形的有效方法。

The release of the orbital septum fat combining with reinforcing orbital septum for lower lid blepharoplaty

Objective To explore the cosmetic effective methods of transfering orbital fat and tightening paries anterior of orbital septum for lower baggy eyelid that＇s skin relaxation,the orbital fat accumulation. Methods We adopt traditional skin cut to treat 36 cases with senile baggy deformity. After the release of the orbital septum along the border of the orbital,the orbital fat was transferred to correct the concave deformity of the lower orbital, and at the same time, the orbicularis oculi muscle flap was overlapped and suspended to strengthen the loosing skin and muscle. Results In 36 cases,30 cases were followed up for 3 N20 months, 29 cases were achieved satisfactory results. Lower eyelid and zygomatic soft tissue accumulation and relaxation have been improved. One case appeared incision mark. There were not any complication. Conclusions It is an effective treatment for senile baggy deformity of lower eyelid.