肿泡眼的重睑成形术

目的 寻求一种安全、可靠的“肿泡眼”治疗方法。方法 通过术中观察，探索“肿泡眼”的解剖特点。针对其解剖特点，术中切除上睑眼轮匝肌下脂肪垫，减少眶内容物，完成重睑。结果 27例患者，疗效满意。上睑臃肿纠正，术后外观自然，效果理想。结论 切除上睑眼轮匝肌下脂肪垫、去除眶内容物、提升眶隔筋膜附着点，在“肿泡眼”的重睑成形术中是必要的。     

肿泡眼的重睑成形术

目的寻求一种安全、可靠的"肿泡眼"治疗方法.方法通过术中观察,探索"肿泡眼"的解剖特点,针对其解剖特点,术中切除上睑眼轮匝肌下脂肪垫,减少眶内容物,完成重睑.结果 27例患者,疗效满意,上睑臃肿纠正,术后外观自然,效果理想.结论切除上睑眼轮匝肌下脂肪垫、去除眶内容物、提升眶隔筋膜附着点,在"肿泡眼"的重睑成形术中是必要的.     

肿泡眼患者重睑隆鼻Ⅰ期成形术

目的：探求治疗肿泡眼理想的手术术式和方法。方法：根据肿泡眼患者的局部解剖特点及面部特征，对常规切开法重睑术加以改进，即适当切除上睑皮肤、肥厚眼轮匝肌、眶隔脂肪和眼轮匝肌下脂肪垫，并同期完成隆鼻成形术。结果：应用本方法完成80例，其中75例术后随访3～6个月，美容效果均满意。结论：对肿泡眼患者施行改良切开法重睑术，并同期施行隆鼻成形，可以获得更为满意的美容效果。     

“水泡眼”的剖析特点及其重睑术

探讨“水泡眼”的剖解特点及其重睑术。针对“水泡眼”的解剖特点施术，强调切除上睑眼轮匝肌下脂肪垫的重要性。本组３０例效果满意，上睑腑肿得到纠正，重睑线流畅。“水泡眼”的重睑术应强调针对其解剖特点而施术，眶隔内脂肪切除不应保守，切除眼累匝股下脂肪垫是必要的。     

眼轮匝肌下脂肪垫的解剖学及整形外科学的研究

目的：研究眼轮匝肌下脂肪垫的解剖结构,和相邻组织结构的关系,评价其在眼部年轻化手术中的应用效果。方法：对成人头颅部人体标本7具（14侧眼部标本）进行眶部解剖研究;对50例术前有明显面部老化征象患者进行了眼部手术,手术中将眼轮匝肌下脂肪垫部分去除。结果：在眼轮匝肌下和上颌骨、颧骨骨膜的浅面,存在有脂肪垫,其大部分分布在眼眶外围,并与周围脂肪垫相连续。50例眼袋患者,术后下睑区平展,眶隔脂肪袋消失,下眶缘沟消失,眶下外侧骨缘轮廓平和。其中19例伴有上睑臃肿下垂患者,术后眼裂增宽,眼睑变薄,无上睑外侧臃肿表现。结论：眼部年轻化手术适当去除眼轮匝肌下脂肪垫,可明显改善手术效果。     

眼轮匝肌后脂肪的解剖组织学及应用进展

眼睑成形术是亚洲流行的整形外科手术之一,部分上睑臃肿患者去除冗余眼轮匝肌和眶隔脂肪后,上睑臃肿外观并未改善,结合上睑解剖,发现该类患者往往是眼轮匝肌后脂肪(ROOF)肥厚导致。虽然单纯ROOF切除或ROOF联合眶隔脂肪切除在重睑术中取得了较好的效果,但缺乏对解剖的深入研究。现对ROOF解剖学、组织学、临床应用的研究进展...     

“水泡眼”的解剖特点及其重睑术

探讨“水泡眼”的解剖特点及其重睑术。针对“水泡眼”的解剖特点施术，强调切除上睑眼轮匝肌下脂肪垫的重要性。本组３０例效果满意，上睑臃肿得到纠正，重睑线流畅。“水泡眼”的重睑术应强调针对其解剖特点而施术，眶隔内脂肪切除不应保守，切除眼轮匝肌下脂肪垫是必要的。     

158例重睑成形术中去除眼轮匝肌下脂肪垫的临床研究

1　临床资料我们自1998年5月～2 0 0 3年3月对15 8例上睑臃肿的单睑者施行重睑成形术,其中男性36例,女性12 2例。年龄16～6 5岁,平均2 5岁。2　方法除眼轮匝肌肌下脂肪垫的显露与切除外,其余步骤均按常规切开法重睑成形术操作。紧贴眼轮匝肌深面,眶隔浅面钝性向眶上缘分离,直至眶上外侧眼轮匝肌完全显露为止,外侧眶缘有一檐盖样膨隆,此即眼轮匝肌下的脂肪垫,将该脂肪垫外侧1 3去除,保留中内部分。去除眶隔脂肪及肌下脂肪垫后可发现上睑外侧臃肿较前明显改善。3　结果术后随访3个月～4年,随访10 3例,术后平均7～10d局部消肿,1～2个月恢复自然…     

肿泡眼切开法重睑成形术式探讨

目的 探讨肿泡眼单睑患者的理想重睑成形术式。方法 针对肿泡眼单睑的解剖特点．对常规切开法重睑成形术加以改进。通过较窄重睑线设计，去除适量松弛皮肤，去除臃肿眶隔脂肪及肥厚眼轮匝肌、睑板前结缔组织，改善重睑形态。结果 本组患者共308例，随访150例，随访时间3～12个月。其中123例效果满意．19例效果一般，8例不甚满意。结论 对于肿泡眼患者可在切开法重睑成形术的基础上，将松弛皮肤、眶隔脂肪、眼轮匝肌及睑板前结缔组织适量去除，术后重睑形态自然流畅。     

肿泡眼切开法重睑成形术式探讨

目的　探讨肿泡眼单睑患者的理想重睑成形术式。方法　针对肿泡眼单睑的解剖特点 ,对常规切开法重睑成形术加以改进。通过较窄重睑线设计 ,去除适量松弛皮肤 ,去除臃肿眶隔脂肪及肥厚眼轮匝肌、睑板前结缔组织 ,改善重睑形态。结果　本组患者共 30 8例 ,随访 15 0例 ,随访时间 3～ 12个月。其中 12 3例效果满意 ,19例效果一般 ,8例不甚满意。结论　对于肿泡眼患者可在切开法重睑成形术的基础上 ,将松弛皮肤、眶隔脂肪、眼轮匝肌及睑板前结缔组织适量去除 ,术后重睑形态自然流畅     

眶脂肪瓣转移矫正老年性上睑凹陷

目的：探讨用上睑外侧眶脂肪瓣矫正老年性上睑凹陷的手术效果。方法：通过上睑整形术中将向外下移位的外侧眶脂肪离断形成蒂在内侧的眶脂肪瓣,在眶隔后移位固定于上睑中内侧,矫正上睑凹陷。结果：应用该法治疗92例老年上睑松弛伴凹陷患者取得满意效果。结论：该法简单易行,效果好,远期效果稳定。     

Improving the Lateral Fullness of the Upper Eyelid

The lateral fullness of the upper eyelid is its convex surface area from the eyebrow to the eyelid crease. Rejuvenation of upper eyelids can be achieved by accenting their fullness. An S-shaped fusiform skin segment is removed from the upper eyelid, with care taken to spare the orbicularis occuli muscle. Approximately 1 ml of fat tissue is excised from the medial compartment by transmuscular incision. The fat is placed in the crease, and the orbicularis occuli muscle is stitched together over the transplanted fat tissue. Imbrication of the orbicularis occuli muscle and insertion of 1 ml of fat tissue into the muscle layers increase the lateral fullness and significantly emphasizes the aesthetic result of upper eyelid blepharoplasty.     

下睑成形术的术式选择

下睑老化的实质是组织的萎缩和松弛，临床上常将下睑老化表现分成四型：（１）下睑皮肤松弛；（２）眼轮匝肌肥厚；（３）眶内脂肪过多而致的脂肪膨出，或眶膈松弛致使脂肪疝出；（４）混合型。下睑成形术的术式较多，本文就下睑老化四个类型应采取的不同术式作了较详细的分析，提出皮肤松弛型可仅切除多余的皮肤。眼轮匝肌肥厚型可切除部分眼轮匝肌，并同时做眼轮匝肌内外眦悬吊术，以减轻下睑低张。而对眶内脂肪疝出或膨出的患者，大多不切除脂肪，只有当眶膈缩紧术仍无法改变下睑袋外观时，才采取切除疝出的眶膈脂肪的术式。同时还强调了颞部除皱术和眼轮匝肌下脂肪垫在下睑成形中所起的辅助作用。     

Central (third) fat pad of the upper eyelid.

A clinical study on the surgical anatomy of the upper-eyelid fat pads was performed on 55 consecutive patients who underwent a blepharoplasty. It was confirmed that the periorbital fat is encapsulated in compartments and that the number of fat pads varies. In 56% of the cases there were two fat pads and in the 44% three fat pads in the upper eyelid. The third fat pad is anatomically and histologically an accessory medial extension of the lateral fat pad. However, for the sake of clarity, the term central fat pad of the upper eyelid is proposed as a denominator of this structure. The purpose of this article is to make the less experienced surgeons aware of variations in the configuration of the periorbital fat and to remind them that after two fat pads are removed from the upper eyelid there might still be a third.     

中老年人上睑凹陷畸形的整形治疗及其成因探讨

目的 为修复中老年人上睑凹陷畸形(下简称上睑凹陷)，提出其针对性的整形手术，并对其发生机制进行探讨。方法 用抽出的适量自体脂肪颗粒，经处理后注射至上睑局部凹陷的眶隔后。结果 经过手术，33例眼部的外观均有明显改善。结论 由于大多数就诊者伴随上睑凹陷越明显下睑袋也越严重的同步现象，所以上睑凹陷可能是由于眶内脂肪组织下垂，致使眼睑同时出现上睑凹陷和下睑凸出的表现。中老年人上睑凹陷畸形是眼部衰老的现象之一，对上睑凹陷处注射自体脂肪颗粒的方法进行填充纠正，可使眼部外貌明显改善并年轻化，且操作简单，疗效可靠。     

Central (third) fat pad of the upper eyelid

A clinical study on the surgical anatomy of the upper-eyelid fat pads was performed on 55 consecutive patients who underwent a blepharoplasty. It was confirmed that the periorbital fat is encapsulated in compartments and that the number of fat pads varies. In 56% of the cases there were two fat pads and in the 44% three fat pads in the upper eyelid. The third fat pad is anatomically and histologically an accessory medial extension of the lateral fat pad. However, for the sake of clarity, the term central fat pad of the upper eyelid is proposed as a denominator of this structure. The purpose of this article is to make the less experienced surgeons aware of variations in the configuration of the periorbital fat and to remind them that after two fat pads are removed from the upper eyelid there might still be a third.Presented at the 10th Congress of the International Society of Aesthetic Plastic Surgery, Zürich, Switzerland, September 11, 1989     

Extended preseptal fat resection in Asian blepharoplasty

The thickness of the upper eyelid is a bothersome condition that can be alleviated by blepharoplasty in Asians. Preseptal fat lies widely deep to the orbicularis oculi in the lower part of the upper eyelid, and the retro-orbicularis oculus fat (ROOF) pad lies in the lateral supraorbital area. We demonstrate the effectiveness of preseptal fat resection (PSFR) extended with ROOF resection in Asian patients. Three levels of PSFR were carried out in 258 eyelids of 129 Asian patients in conjunction with bilateral blepharoplasty: partial PSFR in 84 eyelids, total PSFR in 86, and extended PSFR that included ROOF resection in 68. The series revealed that PSFR was effective in reducing the thickness and heaviness of the eyelid, without major complications. PSFR including ROOF resection is an optional adjunct for Asian patients undergoing blepharoplasty. Nonetheless, the function of the grinding structures in the upper eyelid should be appropriately preserved.     

Surgical advances. A comprehensive approach to surgical rejuvenation of the eyes

Methods to rejuvenate the eye region include shortening of the forehead, raising the brow, improving the upper eyelids by excision of blepharochalasis tissue, and reducing lower eyelid fat pads by a transconjunctival approach and at the same time elevating the stretched lateral canthus by an effective canthopexy. The risks and complications of these procedures are minimal, circumscribing the shortcomings of conventional blepharoplasty.