内窥镜骨膜下剥离面部年轻化手术

为实现面部年轻化，自１９９５年７月起，用自行研制的内窥镜，日本产的电视转换系统，行骨膜下剥离除皱术共１５例。切口小而隐蔽，不脱发，术后肿胀较轻，并发症少，效果良好。就手术适应证，仪器设备，操作方法和结果进行了讨论。认为此种手术的最佳年龄是４０～５５岁。６０岁左右者需加作多层次剥离提紧或吸脂术。年龄再大者则非手术适应证。并强调头皮切口处最大限度地上推和固定对于保证手术效果的重要性。     

内窥镜骨膜下剥离面部年轻化手术

为实现面部年轻化,自1995年7月起,用自行研制的内窥镜,日本产的电视转换系统,行骨膜下剥离除皱术共15例。切口小而隐蔽,不脱发,术后肿胀较轻,并发症少,效果良好。就手术适应证,仪器设备,操作方法和结果进行了讨论。认为此种手术的最佳年龄是40～55岁。60岁左右者需加作多层次剥离提紧或吸脂术。年龄再大者则非手术适应证。并强调头皮切口处最大限度地上推和固定对于保证手术效果的重要性。     

面部骨膜下除皱术

骨膜下除皱术是根据面部老化的病理特点，即骨髂脱钙，体积变小，面部软组织松驰下垂，皮肤弹性下降等进行设计的。目前，许多人手术范围局限于分离颧弓前１／３，限制了面中部软组织的有效提升。     

面部骨膜下除皱术

骨膜下除皱术是根据面部老化的病理特点，即骨骼脱钙、体积变小、面部软组织松弛下垂、皮肤弹性下降等进行设计的。目前，许多人手术范围局限于分离颧弓前１／３，限制了面中部软组织的有效提升。作者通过改进颧弓部入路，完全游离颧弓，面中部软组织及表情肌充分上提，使面部年轻化，８例病人均达到满意的效果，无面神经的损伤及其它手术并发症。     

改良骨膜下综合剥离除皱术100例分析

目的　为了更有效地使面中部老化组织向上提紧复位。　方法　采用扩大的面部骨膜下剥离 ,或加用 SMAS下和皮下多层次综合剥离除皱术。尤其在颧弓部骨膜下进行剥离松解 ,掀起颧弓韧带的起点 ,以解除面中部老化组织上提复位的屏障。　结果　本组 10 0例术后显示恢复了面部各层组织年轻时的解剖关系 ,获得了年轻时鼻唇沟的形态和颌线轮廓 ,效果满意。未出现面神经额支受牵拉损伤的征象。　结论　本法适用于不同年龄 ,尤其是 40岁左右的除皱者     

骨膜下分离加颞深筋膜──骨膜三角瓣技术行面部除皱

１９９１年，Ｒｅｍｉｒｅｚ描述了扩大的骨膜下剥离面部除皱术，笔者按此法进行手术时，仍感下面部特别是下颌区上提不足，鼻面沟消除不明显，影响了整个面部除皱的综合美容效果。为了增加骨膜下除皱术面部上提的幅度，更有效地解决下面部松垂问题和消除加深的鼻面沟，笔者在Ｒｅｍｉｒｅｚ手术方法的基础上设计了耳前颞深筋膜—骨膜三角瓣技术，共为９例病人施行手术，均取得满意效果，无１例面神经损伤。通过实践，笔者认为，本手术方法造成面神经损伤的机会很小，且能更有效地提高面部上提的幅度，使全面除皱效果更为明显。     

改良的中下面部三维综合除皱术在面部年轻化中的应用

目的：探索应用改进的综合方法对中下面部进行三维除皱术,以恢复年轻时的面部立体轮廓形态。方法：局部麻醉下进行中下面部三维除皱术,术中应用了改进的筋膜悬吊、面颊部软组织折叠,下颌部超声去脂、面部局部吸脂、脂肪充填等手术方法;其中将传统的筋膜悬吊改进为多层次的分段提紧和选择性的连续提紧方法。结果：2006年1月～2009年10月间,采用此法完成手术56例,不仅提高了除皱效果,还减少了愈合后瘢痕的形成。结论：通过以上手术方法不仅术后除皱效果良好,而且使面部轮廓形态得到了显著改善,三维面部年轻化的概念也得到了体现。     

Effects of subperiosteal midfacial elevation via an endoscopic brow-lift incision on lower facial rejuvenation

Many techniques have been developed for rejuvenation of the midface. This article describes the technique of subperiosteal midface elevation via an endoscopic brow incision approach developed by the senior author and reviews the results of this technique, with specific emphasis upon the effect on lower facial rejuvenation.     

Endoscopic techniques in facial rejuvenation: An overview. Part I

The use of endoscopic techniques in orthopedic, gynecological, and general surgery has had a significant effect on the traditional techniques in those specialties. The introduction of those techniques to plastic surgery, particularly to aesthetic surgery, has been very slow. However, recent interest in using endoscopic techniques in forehead plasty, corrugator—procerus resection, and breast augmentation has opened up countless possibilities in these and other areas of aesthetic and reconstructive surgery.     

Concept and technic of malleable subperiosteal onlay. Toward a new dimension in facial rejuvenation surgery

We believe that rejuvenation of the shapes and volumes of the face is just as important as "tightening of the skin and muscles". In this way a more complete rejuvenation effect is obtained which is better perceived by others. The SMO technique provides a solution by the use of malleable coral microgranules, which may constitute the first biomaterial of a new generation of plastic and malleable onlays. In this context, a more general volumetric concept of ageing is developed, leading to a modification in our consultation and our treatment. Most importantly, this approach opens a whole new field, that of preventative treatment of facial ageing, which will no doubt be multidisciplinary.     

Endoscopic subperiosteal forehead lift

The author evaluates the new endoscopic treatment of the upper part of the face. The application of the endoscopic method for treating the effects of aging introduces great expectation for aesthetic plastic surgery. The procedure is performed under the periosteum, through tiny incisions near the hairline. The technique consists of releasing the periosteum from the orbital rim and the resection of the muscles: corrugators, procerus, orbicularis, and eventually the frontal muscle. The author reviews 61 cases over a period of ten months.     

Endoscopic facial rejuvenation: Endoforehead,the functional lift. Case reports

Endoscopic techniques have only very recently been applied to aesthetic plastic surgery procedures, especially in carpal tunnel release, in forehead plasties, and in breast augmentation operations. The author briefly outlines his experiences with endoscopic forehead lifts, first reported at surgical conferences in Los Angeles and Buenos Aires in 1992, and now totaling 61 cases performed in the 11 months just prior to the submission of this article. This endoscopic approach to forehead lifting has provided similar and comparable results to conventional coronal forehead lift operations, by means of small incisions made in the scalp area with minimal and fewer complications.Presented at the XIlth Congress of the International Society of Aesthetic Plastic Surgery (ISAPS), Paris, France, September 7, 1993     

面部年轻化手术体会

目的:总结面部年轻化手术的经验,基于求术者个性化差异行手术整复,以期获得良好的美容效果。方法:回顾2000年初～2006年2月对480例患者实施面部年轻化手术的情况。根据患者的要求及衰老表现分别进行了额部、额颞部、颞部、中面部、全面部年轻化手术和/或下睑成形术。①额部除皱术采用冠状切口、发际切口,或者直接在额部皱纹处做切口,进行帽状腱膜下和骨膜下分离,处理额肌、皱眉肌和降眉肌;②颞部年轻化手术采用颞区发际内切口,颞浅筋膜下分离,向外上方向悬吊眼轮匝肌;③中面部年轻化手术,手术切口起于耳轮角,沿耳屏环绕耳垂到耳后,行皮下和SMAS下分离,分别对皮肤和SMAS瓣进行不同方向的悬吊、固定;④下睑成形术采用传统的皮肤入路眼袋成形术手术切口;眼轮匝肌下分离到眶下缘,切开眶隔,重新固定眶脂肪和眶隔在眶下缘的位置;⑤全面部年轻化手术联合应用上述几种手术方式。结果:术后随访3￣24个月,手术效果满意,并发症少,达到了恢复年轻化面容的目的。结论:针对不同衰老表现,通过矫正容量变化,复位易位的组织,合理提升下垂组织,可达到恢复面部年轻化面容的目的。     

Volume and facial rejuvenation

The request of care for facial aging has changed. Patients wish more and more a "natural" rejuvenation. The analysis of the different ways of aging shows that it is important to restore the mid-face volumes in order to obtain the fullness of youth. Numerous techniques have been used to increase the central volumes. After an historical study of the different methods, the authors present the new concepts that give a large place to lipostructure as described by Coleman. This technique can be used alone or in association with other techniques (lifting, collagen or other products injections...). The results are motivating; the process is simple and quick. The post-surgical oedemas are often important, but complications are exceptional. All these criteria correspond to current demands linked to aesthetic surgery considering medico-legal pressure. The future is based on the improvement of good grafts defining more precisely the factors of resorption of adipose graft tissues.